Optimal management of spontaneous intracerebral haemorrhage (ICH) remains one of the highly debated areas in the fields of neurosurgery. Earlier studies comparing open surgical intervention with best medical management failed to show a clear benefit. More recent experience minimally invasive techniques have shown greater promise. We present our experience of 46 patients who presented to neurosurgery, neurology, Medical, Surgical and allied specialities at SIMS / Services Hospital Lahore with clinical and CT scan Brain based diagnosis of Haemorrhagic Stroke and comparison as per outcome between Surgical and Medically treated patients. This is an ongoing study.