Objective – To determine the relationship between the apolipoprotein E (APOE ) epsilon4 allele and in-hospital mortality from intracerebral haemorrhage (ICH). Material and methods – Patients admitted to two acute stroke units with ICH were prospectively evaluated and APOE genotyped. In-hospital survival was recorded in 176 patients. Results – There were 85 men and 91 women, mean age 68 years. Fifty-two (30%) of the 176 patients died in hospital. After adjusting for sex, age, hospital, and race, increased age (P = 0.009) and the presence of the APOE epsilon4 allele (P = 0.026) significantly reduced in-hospital survival. Conclusion – The APOE epsilon4 allele in this population may be associated with poor survival following ICH.