OBJECTIVE The aim of this study was to determine the incidence, clinical features and outcome of nontraumatic hemorrhagic stroke in children. PATIENTS AND METHODS We performed a retrospective study of children with nontraumatic hemorrhagic stroke (codes 430-432 of the International Classification of Disease, 9th revision). RESULTS Between January 1982 and December 1995, twenty-one children less than 16 years of age with nontraumatic hemorrhagic stroke were admitted to our hospital. The incidence rate for hemorrhagic stroke was 2.3 cases per 100,000 per year which constituted 67.7% of all strokes in children. There was a slight predominance of males (1.62:1). Onset of symptoms was sudden in 61.9% of cases and gradual in 38%. The most commo symptoms were altered consciousness (71.4%) and hemiparesis (61.9%). Vascular malformations constituted the largest etiological group (42.8%) followed by the hemorrhages into cerebral tumors (9.5%). In 28.5% of the cases no cause could be found. Surgery was carried out in 38% of the cases. There was an overall mortality of 19% and a post-operative mortality of 25%. CONCLUSIONS Hemorrhagic stroke is a rare event in childhood. Prompt surgical management decreases the mortality rate and improves the outcome of these patients.