To investigate correlation between the neutrophil-to-lymphocyte ratio (NLR) and perihematomal edema (PHE) volume and prognosis after intracerebral hemorrhage (ICH). Methods: Patients with ICH were retrospectively enrolled and divided into good prognosis (mRS≤3) and poor prognosis (mRS> 3) groups according to the Modified Rankin Scale (mRS) scores obtained 90 days after discharge from the hospital. Demographics, clinical baseline data and imaging data were compared between the two groups. Pearson correlation analysis was applied to determine the correlation between NLR and PHE volume. Multivariate Logistic regression analysis was used to determine independent risk factors affecting poor prognosis. Receiver operating characteristic (ROC) curves were used to assess the predictive value of NLR and PHE volume at day 7 from onset on poor prognosis. Results: A total of 177 patients with ICH were included according to the inclusion and exclusion criteria, including 105 patients withgood prognosis and 72 patients with poor prognosis. Univariate analysis showed that PHE volume at 24 h, PHE volume at day 7, relative PHE volume at 24 h, relative PHE volume at day 7, NLR and PLR were significantly higher in the poor prognosis group than in the good prognosis group, and the proportion of brain herniation was significantly higher in the poor prognosis group than in the good prognosis group (P<0.05). Pearson correlation analysis showed that PHE volume within 24 h of ICH was positively correlated with haematoma volume and NLR within 24 h from onset (P<0.05); PHE volume and NLR on day 7 from onset were positively correlated with hematoma volume within 24 h of onset, hematoma volume on day 7 from onset, and NLR (P<0.05). Binary Logistic regression analysis suggested that PHE volume at day 7 from onset and NLR were independent risk factors for poor prognosis in patients with ICH. ROC analysis domonstrated an area under curve of 0.636 (95% CI 0.54～0.73, P=0.006) for PHE volume on day 7 from onset and 0.676 (95% CI 0.585～0.768, P<0.001) for NLR. Conclusion: Higher NLR levels on admission correlated with more severe PHE. Elevated NLR on admission and PHE volume on day 7 from onset were risk factors for poor prognosis on day 90 post-discharge for patients with ICH.