Intracerebral hemorrhage (ICH) is a type of stroke that accounts for about 2 million annual cases worldwide. Hypertension and many other risk factors are well-documented to predispose for this disease. However, the role of serum cholesterol in this regard is controversial. This study aimed to assess different forms of serum cholesterol as risk factors of ICH. This is a case-control study that included 80 patients with imaging- confirmed ICH who were attending Ibn Sena Teaching Hospital, Mosul City from April, 2019 to January, 2020, and other 80 age- and sex-matched volunteer. Demographic data as well as comorbidities were collected by direct interview. Venous blood samples were obtained from each participant, and serum cholesterol was measured spectrophotometric ally. Hypertension was the only risk factor which significantly showed higher frequency in cases than controls. Four sites of ICH were recognized: basal ganglionic (42.5%), thalamus (28.75%), lobar (17.5%), and infratentorial (11.25%). Total serum cholesterol was significantly lower in cases than controls (174±16.7 mg/dL vs 207±18.2 mg/dL) and this significant difference still even when adjusted for hypertension (OR=0.78,95%CI=0.054-0.85, P=0.038). LDL-cholesterol also showed significant dropping in case compared to control however, it was no more significant after adjusting for hypertension. HDL-cholesterol seemed to have no role in ICH. These data strongly suggest the role of low serum cholesterol as a risk factor for ICH.