Remote cerebellar hemorrhage (RCH) is a rare complication in neurosurgery that remains enigmatic both in underlying mechanism and clinical behavior. The range of procedures associated with RCH is diverse and includes both supratentorial and spinal procedures that entail significant CSF loss or lesion resection. The risk factors identified in the literature are not sufficient in predicting the patients at risk of developing RCH. It thereby remains an unpredictable hazard that requires better understanding of its pathophysiology. This study is a comprehensive review of the available literature to provide an understanding of where it stands so far, and to explain an observation in the literature that may have implications for better understanding the disease. Areas of future research are also identified.