The aim of this prospective clinical study was to evaluate the potential of bedside transcranial color-coded duplex sonography (TDS) in the assessment of patients with acute intracranial hemorrhage and respective complications. 74 patients (35 with spontaneous and 27 with traumatic hemorrhage, 12 excluded due to insufficient insonability) underwent 152 TDS examinations. The results were compared to computer-tomography (CT) as well as conventional transcranial Doppler sonography (TcD). The size and localisation of intracerebral hemorrhages as detected in TDS coincided in 39/42 examinations with CT findings; in cases of traumatic intracranial extracerebral hematoma TDS correlated in all but one case (18/19). The TDS findings for the diameter of third and lateral ventricles (n = 126) as for midline-shift (n = 26) showed a good correlation (p < 0.0005) to CT-measurements. TDS appears to be a useful bedside, non-invasive tool in order to detect and exclude intracranial complications in patients with intracranial hemorrhages.