Objective    To investigate the application effect of the new "open + bridge base" 3D guide in the treatment of hypertensive cerebral hemorrhage by precise puncture drainage.   Methods   A retrospective analysis was performed on 32 cases of hypertensive intracerebral hemorrhage collected in our hospital from August 2020 to May 2021. The control group (n=16) underwent puncture under traditional CT positioning. The experimental group (n=16) underwent puncture under the guidance of the new "open + bridge foundation" 3D guide plate. The operation time, target deviation distance and the clearance rate of hematoma 3 days after operation were compared between the two groups.   Results   The operative time of the experimental group was (36.54±3.52) min, the target deviation distance was (0.30±0.03) cm, and the hematoma clearance rate was (91.16±2.22) %, which were better than those of the control group (40.52±3.50) min, (0.49±0.03) cm, (81.93±3.36) %. There were statistical differences in the above indexes (P<0.05).   Conclusions   The new "open+bridge base" type 3D guide for patients with hypertensive cerebral hemorrhage is , safe and feasible, with accurate positioning, which can theoretically improve the prognosis of patients, and has the significance of promotion.