OBJECTIVE： To investigate the effects of Butylphthalide and sodium chloride injection on neurological function and prognosis of elderly patients with hypertensive intracerebral hemorrhage （HICH） after trepanation and drainage surgery. METHODS： During Jan. 2015 to Jun. 2016， 80 elderly HICH patients were selected from our hospital and then divided into control group and observation group according to random number table， with 40 cases in each group. Both group received trepanation and drainage surgery. Control group was given routine treatment. Observation group was given Butylphthalide and sodium chloride injection 100 mL， ivgtt， bid， on the fifth day after surgery， on the basis of control group. Both groups received treatment for 14 d. Clinical efficacies of 2 groups were observed. CSS scores were compared between 2 groups before surgery and 28 d after operation； volume of encephaledema， serum levels of homocysteine （HCY） and substance P （SP） were compared between 2 groups before surgery and 14 d after operation. RESULTS： The total response rate of observation group was 87.5％， which was significantly higher than 67.5％ of control group， with statistical significance （P＜0.05）. Before surgery， there was no statistical significance in CSS scores， volume of encephaledema or serum levels of HCY and SP between 2 groups （P＞0.05）.  CSS scores 28 d after operation， SP levels 14 d after operation were significanthy increased， volume of encephaledema and serum levels of HCY in 2 groups were significantly decreased， and the observation group was significantly better than the control group， with statistical significance （P＜0.05）. CONCLUSIONS： Butylphthalide and sodium chloride injection can significantly improve clinical efficacy and hepatic function damage， relieve postoperative encephaledema， reduce serum levels of HCY and increase SP levels in elderly HICH patients after trepanation and drainage surgery.