Intracranial hemorrhage (ICH) in neonates is a significant concern in Neonatology. That can manifest in various forms. Intraventricular hemorrhage (IVH) is one of the most common types of ICH observed in neonates, particularly in those with gestational ages of less than 30 weeks. It can lead to major complications, in particular, neurological deficits that might be associated with neurological and developmental impairment. The pathophysiology of IVH in preterm infants is multifaceted, involving the fragility of the germinal matrix, fluctuating cerebral blood flow, and impaired autoregulation of cerebral circulation. This chapter highlights the most important factors associated with IVH and discusses the current literature on each factor, aiming to assist in preventing IVH.