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Background: Spontaneous non-traumatic intracerebral hemorrhage (ICH) has a worse prognosis than ischemic stroke. The purpose of this review was to update the reader on epidemiology, prognosis and secondary prevention strategies of ICH. Methods: We performed a selected review from the literature including recent original articles and meta-analyses. Results: ICH has an overall incidence of 24.6 per 100.000 patient years, which is considerably higher in Asian populations. Despite some progress in acute interventions and a great increase in clinical studies over the last decade, mortality of ICH remains high. In addition, survivors remain at increased risk of recurrent hemorrhagic as well as ischemic stroke. Conclusion: Knowledge on risk factors and prevention strategies can greatly decrease the incidence of ICH and improve prognosis of ICH survivors.