<p>Intracerebral hemorrhage is a devastating type of stroke, and its pathological mechanism is very complex. Surgical treatment can effectively treat the primary injury caused by mechanical compression of hematoma after intracerebral hemorrhage. However, there is no effective treatment for the secondary injury caused by a series of pathological processes caused by extravasation of blood components, including inflammatory response, oxidative stress, and excitotoxicity. Therefore, there is an urgent need to develop a novel treatment regimen that can reverse the secondary damage of intracerebral hemorrhage. In recent years, as a powerful biomarker, the role of microRNAs (miRNAs) in diseases has been gradually disclosed. As nanocarriers, the miRNAs delivered by exosomes have become a new treatment method and are widely used in the treatment of various diseases. In this paper, the research progress on the mechanism of exosomal miRNAs in intracerebral hemorrhage and its value in prevention, diagnosis, and prognosis is summarized, hoping to provide some reference for the application of exosomal miRNAs in clinical treatment of intracerebral hemorrhage.</p>