Matrix metalloproteinases (MMP) are a family of proteases involved in the remodelling of the extracellular matrix. In physiological conditions, the activity of MMP is regulated on several levels: gene transcription, activation of inactive precursors, and inhibition by endogenous factors. Loss of control and increased expression and activity of MMP have been implicated in various diseases (cancer, arthritis, vascular aneurysms, atherosclerosis, etc.). In the central nervous system, MMP are involved in the mechanisms associated with neuroinflammation, which is different in vascular and non-vascular diseases. MMP, especially MMP-9, have been shown to induce a high breakdown capacity, especially in the arteriolar basement membrane, leading to cerebral edema and secondary hemorrhage. In human clinical aspects, MMP are associated to intracerebral hemorrhage growth and with the development of complications in ischemic stroke. Combination therapies explicitly involving MMP inhibition could be of value in future treatment strategies.