The invention relates to a directed cranium drilling and tube insertion device for removing intracerebral hematoma, which pertains to medical apparatuses and mainly comprises a localizer, a locating ring and a drainage tube. The locating ring is provided with a lead hole and a screwed hole. The device is characterized in that the inner side face of the locating ring is provided with a convex platform inwards correspondingly. The drainage tube is connected with a multi-ported valve with a medicine injection port, a suction port and an outlet by adopting a double-lumen tube. The medicine injection port is communicated with a small joint and the suction port is communicated with the outlet and a large joint; the localizer is internally provided with a mark strip. The localizer is used with the locating ring, a drill rod, a fixed link and the drainage tube to accurately determine the location and direction of cranium drilling as well as tube insertion direction and depth for the aspiration drainage of hematoma so as to completely eliminate the hematoma, thereby being capable of effectively treating diseases such as hypertensive cerebral hemorrhage, intracranial hematoma and the like. The device accurately and quickly finds the direction and has complete functions and simple operation.