We report a case of pediatric intracerebral hemorrhage with cerebral herniation treated with stereotaxic minimally invasive surgery. A 4-month-old premature male infant with vitamin K deficiency presented to the emergency department with focal seizures and vomiting. A computed tomography scan revealed a massive intracerebral hemorrhage in the left frontal lobe with cerebral herniation. The child successfully underwent stereotaxic minimally invasive surgery hematoma evacuation, and the neurological function improved significantly. Brain magnetic resonance imaging was performed to further characterize the lesion, but no intracranial vascular malformation was found. Overall, the neurological function was completely recovered at the 18-month follow-up, and there were no postoperative complications such as infection, rebleeding and seizures.