Intracerebral hemorrhage (ICH) accounts for 20% of all strokes; caused by the collection of blood within the cerebral parenchyma as the result of vascular rupture. Taking into account its etiology, primary hemorrhages are the most common and are caused by the vascular wall weakness as a result of chronic arterial hypertension or due to degenerative processes as amyloid angiopathy. Secondary causes include arteriovenous malformations, tumors, hemorrhages induced by drugs and substance abuse. The most important risk factors for developing ICH are arterial hypertension, smoking, substance abuse (alcohol and drugs). Hemorrhage location and bleeding volume determine clinical manifestations. In order to distinguish between ICH and other ischemic or structural lesions, both computed tomography (CT) and magnetic resonance imaging (MRI) may be used for the diagnosis. To determine the most likely bleed cause, bleed location and microbleed detection (only detected by MRI) are necessary. Treatment for patients with ICH is fundamentally medical, and they must be cared for in a hospital with stroke unit. Surgical treatment is only recommended for a reduced number of carefully selected cases.