Circulating leptin is associated with cardiovascular events but the relationship between leptin and the clinical outcomesof intracerebral hemorrhage (ICH) is unclear. This study was to investigate the relationship between circulating leptinand the short-term clinical outcomes of ICH. Fifty-seven patients with hypertensive ICH (stroke group), 50 patients withhypertension (hypertension group), and 41 healthy subjects (control group) were recruited to this study. Serum levelsof leptin were measured by radioimmunoassay. The serum level of leptin in the stroke group (14.6 ± 3.3 ng/L) wassignificantly higher than in the hypertension (10.2 ± 2.9 ng/L, P < 0.05) and control group (4.7 ± 3.3 ng/L, P < 0.01).Nine patients (15.8%) in the stroke group died during hospitalization. The mean National Institute of Health StrokeScale (NIHSS) score of the surviving patients at admission and before discharge was 16 ± 6 and 9 ± 5, respectively (P< 0.01). There was a significant correlation between the serum leptin level and predischarge NIHSS scores (r = 0.62,P < 0.01). After adjusting age, sex, ICH volume and location, fasting blood glucose, fasting insulin levels, and systolicblood pressure (SBP) multivariate analysis showed that a high leptin level (>10 ng/L) was an independent predictor forin hospital mortality (adjusted risk ratio (RR), 3.6; 95% confidence interval (CI): 1.22'17.62; P = 0.02). In conclusion,serum leptin levels were increased in patients with hypertensive ICH. High leptin levels were associated with a poorfunctional recovery following ICH.