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The current treatment spontaneous intracerebral hemorrhage (sICH) is limited. To determine the optimal time window for minimally invasive surgery in patients with sICH. sICH patients with a hematoma volume of 30–80 mL in the basal ganglia region were included in our study. A total of 357 patients were divided into groups according to different operative times from ICH onset (group 1: 0–6 h, group 2: 6–12 h, group 3: >12 h) and hematoma volumes (30–50 mL and >50 mL). All patients were followed-up for three months' post-operation, and their clinical outcomes were compared. In the three groups of patients with hematoma volumes of 30–50 mL, the rebleeding and mortality rate were higher in group 1 than groups 2 and 3 (p <.05). The activities of daily living evaluated by Barthel Index (BI) three months' post-operation was significantly lower in group 3 than other groups (p <.05) and group 2 had the highest proportion of good outcomes. Among the patients with the hematoma volumes of 50–80 mL, the rebleeding risk was higher in group 1 than groups 2 and 3 (p <.05). However, there were no significant differences in mortality rates among these three groups. Moreover, group 1 had significantly higher BI than groups 2 and 3 (p <.05). Minimally invasive surgery is safe and effective in patients with sICH. 6–12 h after sICH onset is the optimal surgical window for patients with hematoma volumes of 30–50 mL, while ultra-early (≤6 h) may achieve better results in patients with hematoma volumes of >50 mL. [ABSTRACT FROM AUTHOR]