Cut out and remove any dead or diseased branches. Also remove dead flowers. Cuts should be made below the dead area, so that only living tissue remains. This step can be done at any time of the year, not only in the spring. When the plant is actively blooming you should deadhead, or remove the dying flowers, several times per week.
Locate and remove the oldest, thickest branches. These should be cut as close to the ground as possible. You should try to remove about one-third of them. This opens the plant up to light and air as well as promotes new growth. If you are pruning the plant to control the size, skip this step.
Prune all stems on the plant back to a height of no more than 12 inches. This will cause the plant to put out all new growth, which will encourage an abundance of flowers. This step is not necessary, but some gardeners prefer the look of a Little Lamb hydrangea with all new growth, and this will also keep it looking light and airy.