Background: Intracranial hematoma is the collection of blood in the various intracranial spaces. Knowledge of patterns, origins/causes, and outcomes of ICH conditions are important for decision-making for urgent surgical interventions such as craniotomy and hematoma evacuations. No prior study was conducted in our setup. This study aimed to assess patterns and management outcomes of intracranial hematoma at Jimma University Medical center. Method: An institution-based prospective cross-sectional study design was conducted at Jimma University Medical Center, Jimma, Ethiopia for 6 consecutive months from June to December 2020. The data were cleaned and entered into Epidata version 3.1 and then exported and analyzed using SPSS Version 24. Results: A total of 91 neurosurgery-eligible patients were recruited during the study period with a mean age of 34 years. The majority of neurosurgery patients were males 73 (80.2%) and more common in reproductive age groups (62.6%), from rural areas (50.5%). About 93.4% of patients reported a history of trauma and road traffic accidents & fighting account for 63.8% of the trauma cases. Sixty-five percent of patients arrive in the hospital within 24 hours. Upon presentation, loss of consciousness (48.4%), convulsion (11%), aspiration (9.9%), and increased ICP (12%). The majority (49.5%) of the patients had mild head injuries. The focal neurologic deficits were hemiparesis (29.7%) and hemiplegia (5.5%). Acute epidural hematoma (68.1%) was a common finding followed by sub-acute subdural hematoma. Of the total study participants, 11% of the patients died. All the surviving patients were accessed after one month of discharge and re-assessed, 66 patients had good neurologic (62 uppers and 4 lower good recovery), 11 patients had some disability (7 lower and 4 uppermoderate disabilities), two patients had a severe disability and two patients (those among severe disability) had died. Conclusion: Trauma was invariably the cause of intracranial hematoma and patients with low GCS, papillary abnormality, aspiration, and increased ICP had an increased risk of dying from their illness. It is good to formulate policy to enhance injury prevention and bring health-oriented behavioral change
