BACKGROUND Systemic inflammation plays a critical role in the pathophysiological process of intracranial hemorrhage (ICH). Recently, the platelet-to-lymphocyte ratio (PLR) has become a research focus that indicates inflammation in various diseases. Thus, this study aimed to investigate the predictive value of PLR in patients with acute ICH. MATERIAL AND METHODS This study was performed in a single teaching hospital. Glasgow coma scale at hospital discharge (GCSdis) and modified Rankin score (MRS) at 6 months were recorded as short-term and long-term neurological outcomes. Ordered and binary logistic regression methods were used to explore the associations. RESULTS Finally, data on 183 ICH patients were included. A knot of PLR around 100 was detected and applied in the extended ordered logistic regression models. For PLR >100, PLR on ICU admission was significantly associated with worse GCSdis (from Model 1: OR: 1.004, 95% CI 1.001-1.007 to Model 4: OR: 1.006, 95% CI 1.002-1.009) while the PLR on Emergency Department (ED) admission was insignificant. For PLR ≤100, neither the PLR on ICU or ED admission was associated with GCSdis level. In the quartile grouping analysis, PLR Q2 was used as a reference level. Both Q3 and Q4 on ICU admission were significantly associated with lower GCSdis level (OR, 3.30; 95%CI 1.38-7.88; and OR, 3.79; 95%CI 1.54-9.33, respectively), while Q1 was insignificant. All 4 quartiles of PLR on ED admission were not associated with GCSdis. CONCLUSIONS Only higher PLR value on ICU admission but not on ED admission was associated with worse GCSdis.