Spontaneous intracerebral hematoma (SICH), also known as spontaneous non-traumatic intracerebral hematoma, is a hemorrhage in the cerebral parenchyma that is non-traumatic and is not linked to vascular malformations (arteriovenous malformations, aneurysms) or tumors. It is associated with various risk factors like age, gender, tobacco use and most importantly with hypertension-related degenerative changes that cause the spontaneous rupture of vessels in the cerebral lobes, basal ganglia, thalamus, brainstem, and cerebellum. Despite lower incidence than ischemic stroke, SICH remains one of the leading causes of mortality and disability up to this day. The main treatment is supportive. There is no consensus on its surgical management because of conflicting results on safety and efficacy across studies. This retrospective study aims to compare mortality rates of patients with SICH receiving best medical care and one of the four types of surgical treatment defined below: craniotomy with the evacuation of the hematoma (I), minimal invasive methods of treatment (II), ventricular drainage (III) and craniectomy without hematoma removal (IV). We analyzed the charts of 90 patients with SICH hospitalized from 2015 to 2017. The study describes the age, sex, the neurological status of patients at admission using the Glasgow Coma Scale (GCS), the location of the hematoma and its volume by neuroimaging (CT) as well as the type of surgical treatment provided and their result by assessing mortality. Patients had a mean age of 55.6 years, of them 65,5% men, with a GCS between 5 and 15. Eighty percent of them had a diagnosis of stage II arterial hypertension and were not compliant to their treatment. The mean volume of the hematoma was 69%, with the following location: 53,3% subcortical, 40% deep HICS and 6,6% primary ventricular HICS. 47 patients had craniotomy with the evacuation of the hematoma (I), 24 patients had minimal invasive methods of treatment (II), 17 patients had a ventricular drainage placed (III) and 2 patients had a craniectomy without hematoma removal (IV). 29 patients died following the surgery (32,2%). The mortality was as follows: in I group – 12 (25%), II – 4 (16, 6%), III – 12 (70, 58%), IV – 1 (50%). The minimal invasive treatment had the lowest mortality while the ventricular drainage had a significant one. Thus, the safety and efficacy of the intraventricular drainage can be questioned further in bigger, randomized studies.