Although ICH has traditionally lagged behind ischemic stroke and aneurysmal subarach- noid hemorrhage in terms of evidence from clinical trials to guide management, the past decade has seen a dramatic increase in studies of ICH intervention. Population-based studies show that most patients present with small ICHs that are readily survivable with good medical care.1 This suggests that excellent medical care likely has a potent, direct impact on ICH morbidity and mortality. This guide- line serves several purposes. One is to provide an update to the last American Heart Association/American Stroke Association ICH guideline, published in 2010, incorpo- rating the results of new studies published in the interim.2 Another equally important purpose is to remind clinicians of the importance of their care in determining ICH outcome and to provide an evidence-based framework for that care. To make this review brief and readily useful to practic- ing clinicians, background details of ICH epidemiology are limited, with references provided for readers seeking more Ongoing studies are not discussed substantively because the focus of this guideline is on currently available therapies; however, the increase in clinical studies related to ICH is encouraging, and those interested may go to http:// www.strokecenter.org/trials/ for more information. Also, this Table 1. Applying Classification of Recommendations and Level of Evidence A recommendation with Level of Evidence B or C does not imply that the recommendation is weak. Many important clinical questions addressed in the guidelines do not lend themselves to clinical trials. Although randomized trials are unavailable, there may be a very clear clinical consensus that a particular test or therapy is useful or effective. *Data available from clinical trials or registries about the usefulness/efficacy in different subpopulations, such as sex, age, history of diabetes, history of prior myocardial infarction, history of heart failure, and prior aspirin use. 