Introduction Spontaneous intracerebral hemorrhage (sICH) accounts for about 15% of strokes and is associated with high mortality, severe disability, and unfavorable functional outcome. Information regarding factors contributing to early neurologic deterioration after stroke can guide the early management strategies and lead to more favorable outcomes. The aim of our study was to evaluate the predictive value of admission serum D dimer level in patients with primary ICH regarding their outcome Patient and methods: In our present study, we included 116 patients diagnosed with spontaneous ICH, their mean age 62.54±11.45 years and ranged from 22-90 years with median of age 63 years. Males were 57.8% and 42.2% were females. Most of our patients were right handed 96.6%. All patients were subjected to Full history taking, General and neurological examination with assessment of neurological function on admission using National institutes of Health Stroke Scale (N.I.H.S.S.). Serum D dimer level and Computerized Tomography on admission. All the included patients were followed up, both clinically using the NIHSS score and mRS, radiologically with CT brain after 1 week and 4 weeks of the onset to assess the growth, complications or resolution. Results: showed that the 30 day mortality was about one third of the patients. Elevated serum D dimer level on admission positively correlates with the 30 days mortality and poor outcome measured by mRS Conclusion: Admission serum level of D dimer, has a significant predictive value of the 30 day mortality and disability in cases of SICH.