BACKGROUND: The association between pre-intracerebral hemorrhage (ICH) statin use and clinical outcomes after intracerebral hemorrhage (ICH) is still conflicting. Recently, some studies investigating the effects of in-hospital statin use after the onset of ICH have been published. To provide a more complete picture of the clinical effects of statin use in ICH, we performed a systematic review to examine whether statin use influences clinical outcomes. METHODS: We conducted a systematic review of literature in the Cochrane Library, MEDLINE, EMBASE, and the China National Knowledge Infrastructure database. RESULTS: Twenty-one studies were included in our systematic review. Metaanalysis of 12 studies suggested that pre-ICH statins use did not significantly decrease mortality when aggregated across all time points tested-that is, inhospital or at 30 or 90 days (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.70-1.03). Meta-analysis of 7 studies suggested that pre-ICH statins use did not significantly affect poor functional outcomes, defined as a modified Rankin Scale (mRS) score of 3-6 (OR, 0.93; 95% CI, 0.72-1.18) or mRS score of 4-6 (OR, 0.92; 95% CI, 0.60-1.40). Meta-analysis of 7 studies suggested that in-hospital statin use significantly decreased mortality when aggregated across all time points tested (OR, 0.37; 95% CI, 0.28-0.50). Statin discontinuation was independently associated with poor clinical outcome. CONCLUSIONS: The patients with pre-ICH statin use did not improve clinical outcomes. However, in-hospital statin use can significantly decrease mortality after ICH. In-hospital statin therapy might be beneficial for patients with ICH.