Among 145 cases of spontaneous thalamic hemorrhage, stereotactic aspiration of the hematoma was done in 75 cases in which the hematoma was greater than 6 ml and the limbs on the affected side could not be elevated. Thirty-one of 40 operated cases with a long axis greater than 3.3 cm were capable of returning to useful activity 6 months postoperatively (excellent to fair). The results 6 months from onset in the 145 cases were as follows: 43% excellent or good, 32% fair, 11% poor and 13% dead. These results appear to indicate that stereotactic aspiration can produce improvements in therapeutic results for cases of thalamic hemorrhage.