Purpose is to improve the method of endoscopic aspiration by means of new technique of hypertensive hematoma extraction in a transparent environment, but through a small puncture channel. Material and methods. In 2017 the authors have introduced a new method of hypertensive hematoma extraction through the 6.5 mm ventriculoscope trocar. The trocar traditionally is being manipulated as the main tool and its entire lumen is used for clots aspiration along with the wash liquid; the novelty of the improvement is to make the trocar serve as the port. Through the troacar lumen we have delivered 6 degrees viewing optics and 1.5 mm silicone catheter, connected to the suction device. We didn’t fill in the trocar with any medium. By the catheter, under the visual control, we did aspirate the liquid fraction of the hypertensive hematoma and the loose clots. Dense clots were vacuum fixed to the tip of the catheter, and they were taken out along with the catheter through the lumen of the trocar. In N.V. Sklifosovsky Research Institute of Ambulance Neurosurgery Department since 01.01.17 till 01.01.18 five patients have survived the new procedure. Results. Among the 5 operated patients, the neurological deficit remained at the same level at the time of the discharge from the neurosurgical department in 2 patients, neurological clinic improved in 3. There was no recurrence of hemorrhage after the surgery. In all cases we succeeded to extract more than 80% of the initial hypertensive hematoma volume. Conclusion. The improved method of endoscopic aspiration of hypertensive hematoma through trocar by means of silicone catheter in a transparent aerial environment, demonstrated high efficiency at rapid evacuation of various size hypertensive hematomas.