Abstract: Clinical manifestations. CT manifestations and prognosis of fifty hypertensive patients with severe hematomas in basal ganglia were investigated. According to the extension of hematomas there were five types shown on CT: type Ⅰ （17 cases ）, the mass was located in the external capsule; type Ⅱ（14 cases ）, the internal capsule was invaded: type Ⅲ （6 cases ）.the internal capsusal and thalamus or hypothalamus were in vaded ; type Ⅳ （5 cases ）. the bleeding was mainly located at the thalamus; type Ⅴ （8 cases ）. the hematomas extended to the midbrain or the pons. Total mortality of the patients after operation is 42%: in type Ⅰ 17. 65%,in type Ⅱ 28. 57% .in type Ⅲ 83. 33%,in type Ⅳ 20.00% and in type Ⅴ 100.00%, respectively. Patients with type Ⅰ and Ⅱ should be operated as early as possible. The operation in patients of type Ⅲ usually complicated with the hemorrhage of the upper digestive tract and should be handled with great care. Puncture and aspiration of cerebral ventricles are enough for patients of type Ⅳ. It seems thatno operation for patients of type Ⅴ is indicated.