Intracerebral hemorrhage (ICH) is one of the most severe forms of stroke, yet several factors continue to undermine effective patient management: (1) Contrary to ischemic stroke, no dedicated ICH classification has so far been established for routine clinical use. (2) The diagnostic workup for patients presenting with acute ICH has not been standardized (3) Specific ICH treatment options remain limited. (4) Major uncertainties exist regarding preventive interventions for unruptured, hemorrhage-prone lesions such as cerebral AVMs, aneurysms, and cavernous malformations. This paper summarizes recent progress in establishing an etiology-based ICH classification, a pragmatic stepwise algorithm for the diagnostic workup of ICH, and novel treatment strategies such as rapid blood pressure-lowering therapy for acute ICH.