Brain parenchymal hemorrhage is a common neuroimaging finding in an emergency room. It is considered primary in the absence of an underlying lesion or coagulopathy. Secondary hemorrhages are caused by various structural causes and pathologies. The goals of imaging are to identify the hematoma, assess factors that have prognostic significance, assess associated complications, identify an underlying etiology whenever possible, and guide therapeutic decisions. The review provides an illustrative review of various etiologies of non-traumatic brain parenchymal hemorrhage and their imaging evaluation.