To investigate the efficacy of self-made transparent working channel assisted neuroendoscopic surgery in the treatment of ventricular casting hematoma. Methods The clinical data of patients with intraventricular cast hematoma treated in Baise People's Hospital from September 2017 to December 2019 were retrospectively analyzed. They were divided into observation group and control group according to their operation methods. Results There was no significant difference in gender, average age, GCS score at admission and preoperative hematoma volume between the two groups (P＞0.05). The operation time, intraoperative bleeding, indwelling time of drainage tube, hematoma clearance rate within 24 hours after operation, postoperative intracranial infection, shunting hydrocephalus, mortality within 30 days, GCS score on the 1st, 14th, 28th and 6m after operation and NIHSS score on the 6th day after operation in the observation group were statistically significant (P＜0.05). Conclusion Compared with lateral ventricular puncture and external drainage, although selfmade transparent working channel assisted neuroendoscopic surgery for intraventricular cast hematoma has more bleeding and longer operation time. However, this operation method can effectively shorten the indwelling time of drainage tube, reduce postoperative complications, reduce the mortality and disability rate of patients, and improve the quality of life of patients after operation.