OBJECTIVE: Cerebrovascular and cardiovacular diseases are the main causes of death in patients with chronic renal failure (CRF) and who are undergoing hemodialysis. We investigated the risk factors for the development of intracerbral hemorrhage (ICH) in this population. METHODS: We retrospectively reviewed a total of 53 patients who underwent hemodialysis for CRF and who developed ICH. The patients' demographics, including gender and age, the duration of the hemodialysis, the initial Glasgow Coma Scale (GCS) score, the underlying causes of CRF, the past medication history, the location and amount of hemorrhage and the therapeutic modality for ICH were analyzed. RESULTS: The development of ICH significantly increased in the old age patients (> or = 65 years), the patients with a prolonged history of hemodialysis (> or = 5 years) and the patients with hypertension (p < 0.05). However, gender, anemia (hemoglobin < or = 8.0 g/dl) and the initial systolic blood pressure (> or = 180 mmHg) were not significantly correlated with the occurrence of intracerebral hemorrhage in the hemodialyzed patients. CONCLUSION: The present study suggests that the development of ICH in patients with CRF is increased in the old age patients, the patients with a prolonged history of hemodialysis and the medically co-morbid patients. To avoid this disastrous complication, we should try to minimize the modifiable risk factors of hemorrhagic stroke in CRF patients.