Original Articles Methods: A retrospective, observational cohort study including all patients with brainstem hemorrhage from January 2014 to December 2017. The clinical presentation, location of hemorrhage, complications and clinical outcomes were analyzed. Results: Of 1921 stroke patients, 219 had hemorrhagic stroke)11.4%(, of whom only 10)4.6%(had brainstem hemorrhage, comprising 0.5% of all stroke patients. All patients were men; mean age was 58.5 years. Most frequent presenting symptoms were headache)70%(, unilateral weakness)60%(, and loss of consciousness)50%(. All patients had hemorrhage in pons, 5 had concomitant cerebellar hemorrhage)50%(, one had medullary hemorrhage, and one midbrain hemorrhage)10% each(. Mean ICU stay was 17 days; mean hospital stay was 58 days. At the time of discharge, three)30%(had mRS of 0-2, 5)50%(had mRS of 3-5, whereas 2)20%(had died. Glasgow coma scale)GCS(of >8 at presentation was associated with a good outcome at three months)p=0.03(. Presentation within six hours of symptom onset)p=0.233(, hypertension on presentation)p=0.233(, and age less than 60 years)p=0.065(did not affect discharge outcomes. Conclusion: Brainstem hemorrhage occurred in 0.5% of all stroke patients. It was associated with high morbidity and mortality. Low Glasgow Coma Scale at presentation was associated with poor outcomes.