Intracerebral hemorrhage has recently transitioned from being a neurosurgical entity into a condition where nonsurgeons have more participation in the medical decision making. Despite recent advances in the management of intracerebral hemorrhage (i.e., STICH trial and recombinant factor VII trial), guidelines published in 1999 remain the only available therapeutic consensus. The goal of this review is to address frequently encountered case scenarios when managing patients with spontaneous or nontraumatic intracerebral hemorrhage, both acutely and long-term.