Twenty six cases of cerebellar hemorrhages were reviewed and analyzed. Two patients were comatose on admission and showed clinical evidence of brainstem compression; they were successfully revived after evacuation of the hematomas. This was in contrast with six other comatose patients who did not have evacuation and subsequently died within 48 hours. The other eight cases of so-called benign cerebellar hemorrhage ran a more benign course and recovered without any operative procedures. It is suggested that prompt diagnosis with computed tomography, even in comatose patients, and immediate removal of the hematoma in this group, might result in a better prognosis with this highly lethal condition.