According to the Global Burden of Disease Stroke Collaboration, stroke is the second leading cause of death worldwide. Intracerebral hemorrhage (ICH) accounts for about 15% of strokes [1]. Approximately 10% of ICHs are located in the cerebellum. Thus, cerebellar ICH affects approximately 35,000 patients annually in Europe and the United States [2], [3], [4], [5]. Prognosis of was consistently reported as poor, with 30-day case fatality varying from 30% to 50% [6], [7], [8], [9] Clinical deterioration usually results from brainstem compression due to the local mass effect of the hematoma and/or development of hydrocephalus, resulting in intracranial hypertension and death [6], [7]. Early hematoma evacuation can prevent life-threatening complications such as brainstem compression or blockage of the 4th ventricle followed by obstructive hydrocephalus. Based on a weak professional consensus and common practice, neurosurgical intervention (i.e., craniotomy with hematoma evacuation with or without external ventricular drainage) is performed more frequently in cerebellar than supratentorial ICH, although evidence is scarce and practices vary widely between neurological or neurosurgical teams. Therefore the French Society of Neurosurgery (SFNC) and the French Society of Vascular Neurology (SFNV) sought to establish joint guidelines for French neurovascular teams.