Lobar intracerebral hemorrhages (ICHs) involve the white matter of the cerebral lobes, and originate at the corticosubcortical gray matter-white matter junctions. Lobar hemorrhages are distinct from other forms of ICH in their clinical presentation, causes, prognosis, and management. Lobar hemorrhage has been thought to have a better prognosis than the deep hemispheric (putaminal, thalamic) and posterior fossa hemorrhages. The case fatality rates reported have ranged between 11% and 32%, in comparison with 42% for basal ganglionic and thalamic ICH, and 43% for posterior fossa hemorrhages. The observed differences in case fatality between lobar and deep ICH probably reflect variations in hematoma size and mass effect more than their superficial versus deep location. The value of medical and surgical therapy for lobar ICH will ultimately have to be determined by clinical trials involving randomization of comparable groups of patients to one or the other type of treatment.