Objective To investigate the effects of traditional craniotomy and minimally invasive neuroendoscopic surgery on NIHSS score and BI score in patients with cerebral hemorrhage. Methods The clinical data of 200 patients with cerebral hemorrhage admitted to our hospital from January 2022 to January 2023 were retrospectively collected. According to different treatment methods, the patients were divided into control group (traditional craniotomy, 150 cases) and observation group (minimally invasive neuroendoscopic surgery, 50 cases). Postoperative neurological function recovery (NIHSS score), postoperative activities of daily living (BI score), operation-related indicators, and postoperative complications of the two groups were collected and compared. Results At 1 month, 2 months, 3 months, 6 months and 12 months after surgery, the NIHSS score of both groups decreased significantly with the increase of postoperative time. One month after surgery, the NIHSS score of the two groups was not significant (P>0.05), and the NIHSS score of the observation group was significantly lower than that of the control group at 2 months, 3 months, 6 months and 12 months after surgery (P<0.05). At 1 month, 2 months, 3 months, 6 months and 12 months after surgery, BI scores of both groups increased significantly with the increase of postoperative time. At 1 month after surgery, BI scores of the two groups had no significant difference (P>0.05), and at 2 months, 3 months, 6 months and 12 months after surgery, BI scores of the observation group were significantly higher than those of the control group (P<0.05). The operation time and postoperative hospital stay in the observation group were significantly shorter than those in the control group, and the amount of intraoperative blood loss was significantly less than that in the control group (P<0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (P<0.05). Conclusion Compared with traditional craniotomy, neuroendoscopic minimally invasive surgery can promote the recovery of nerve function and improve the ability of daily living in patients with cerebral hemorrhage after treatment. In addition, the operation time of this surgery is shorter, the amount of intraoperative bleeding is less, the length of hospital stay is shorter, the incidence of complications is lower, and the prognosis is better.