Nontraumatic primary intraventricular hemorrhage (PIVH) is characterized by direct bleeding into the neuroventricular system. A very rare condition, PIVH accounts for 3% of all spontaneous intracerebral hemorrhages. Hypertension is a major cause of PIVH. Reports about PIVH in the literature are infrequent and it appears to be a relatively benign condition. Between 1998 and 2001, 15 patients with PIVH were evaluated in the Departments of Neurosurgery of Yüzüncü Yil and Pamukkale Universities; their prognosis and results of treatment with external ventricular drainage (EVD) were recorded. The diagnosis was established easily and rapidly with computed tomography. Prognoses of the patients were made by the Glasgow Coma Score (GCS). Hypertension was the most common etiology (n = 9, 60%); the prognosis for survivors (73.3%) was good (mortality, 26.6%). Elderly patients, who scored low on the GCS, and patients with coagulopathy had poor prognoses. All patients with PIVH underwent surgery with EVD within 24 hours of their hospital admission. Applying EVD had positive results and influenced the prognosis and early and late complications of PIVH accordingly.