We have evaluated the relationship between carotid atherosclerotic change and intracerebral hemorrhage patients. Forty-eight patients with intracerebral hemorrhage treated at our institution were included in this study. Their ages ranged from 38 to 86 years old (average: 61.5 years). There were 28 cases of putaminal hemorrhage and 20 cases of thalamic hemorrhage. Evacuation of hematoma or ventricle drainage was performed in 18 cases within 3 days after the onset of symptoms. The outcome in these cases was that 40 patients survived and 8 patients died. Carotid atherosclerosis was evaluated by B mode-ultrasonography. The severity of carotid atherosclerosis was assessed by using two indicators; incidence of carotid atherosclerosis and maximum percentage diameter of the stenosis. Carotid atherosclerosis on B mode-ultrasonography was detected more frequently in patients with thalamic hemorrhage (84.2%) than in those with putaminal hemorrhage (51.7%). Maximum percentage stenosis of thalamic hemorrhage (17.2 +/- 15.2%) was higher than maximum percentage stenosis of putaminal hemorrhage (6.4 +/- 9.7%). In conclusion, carotid atherosclerosis was an effective indicator of not only ischemical cerebrovascular disease but also of intracerebral hemorrhage.