Abstract: This paper analysed the causes of death in 145 aged cases of hypertensive cerebral hemorrhage The results showed that the direct causes of death in the acute stage were hippocampal gyrusherniation（55%）and tonsillar herniation （52%）, and ihe secondary were pulmonary infection （29%） with multiorganic failure, such as hemorrhage of gastrointestinal tract（17.9）, acute heart failure （2.1%）, myocardial infarctian （1.4%） and renal failure（0.7%）. These factors were responsible for the death in most patients.