Fifty cases of supratentorial intracerebral hematomas associated with hypertension are analyzed. The best treatment of the intracerebral hematomas is not settled. The authors reviewed and analyzed the literature and they suggest that the small hematomas should be managed conservatively as well as those patients in deep coma. The subcortical hematomas usually improve with surgical removal. In the deep ganglionic type the initial treatment is clinical. If no improvement occurs the hematoma should be removed with microsurgery tecnique.