Spontaneous cerebellar hemorrhage was rarely diagnosed in the past and therefore thought to be infrequent but after the introduction of CT scanning has been more commonly diagnosed. A series of 28 cases of spontaneous cerebellar hemorrhage is analyzed concluding that the radiological and clinical aspects should be considered, instead of adopting the diameter as surgical indicator. An accurate monitoring of the patient's clinical status is very important since its worsening is an absolute indication for surgery independently of the size of hematoma.