Abstract: Objective To investigate the clinical characteristics and prognostic factors of primary intraventricular hemorrhage (PIVH). Methods A retrospective study was conducted. The data of PIVH patients in Jinhua Municipal Central Hospital from January, 2011 to January, 2016, including demography, medical history, radiological imaging and prognosis, was collected to evaluate the etiological causes, clinical features and prognostic factors. Results A total of 41 patients with PIVH were enrolled in the study finally, which account for 3.8% of patients with hemorrhagic stroke. In all 41 patients, 61.0% were male (25 cases) and the mean patient age was (50.1±12.3) years. Hypertension was the most common medical history (20 cases, 8.8%) and headache was the most common initial symptom (25 cases, 61.0%). According to cause of hemorrhage, patients were divided into idiopathic group (24cases, 58.5%) and vascular structural abnormality (VSA)-related group (17 cases, 41.5%). Age, proportion of hypertension and GCS in the idiopathic group were all significantly higher than those in VSA-related group (P<0.05). According to the modified Rankin scale (mRS), 25 cases (61.0%) have favorable outcome (mRS:0-2) and 16 cases (39.0%) have unfavorable outcome (mRS:3-6) during the 6-month follow-up. The unfavorable outcome group have significantly higher Graeb score and proportion of acute hydrocephalus, and lower GCS than favorable outcome group (P<0.05). The idiopathic group has better outcome than VSA-related group (P<0.05). Conclusion PIVH is a rare type of hemorrhagic stroke with a poor outcome. We recommend routine cerebral angiography to identify etiological cause. High Graeb score, low GCS, acute hydrocephalus and VSA-related PIVH are associated with poor prognosis.