Intracerebral hemorrhage (ICH) is a severe and life-threatening condition caused by the rupture of blood vessels within the brain. The management of ICH in the ICU is a critical process involving stabilization, control of intracranial pressure (ICP), management of coagulation, prevention of complications, and rehabilitation. Recent guidelines underscore the importance of a systematic, evidence-based approach in managing patients with ICH, which this guide aims to elaborate for ICU residents, offering practical insights into the management and decision-making process. The chapter follows the flowchart-based management with emphasis on recent updates to optimize patient care and outcomes [1, 2] [Ref. Algorithm 7.1].