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Background Intracerebral haemorrhage (ICH) has historically been associated with a high proportion of stroke-related deaths and significant morbidity. This single-centre cohort analysis aims to evaluate the outcomes of patients with ICH presenting at Fiona Stanley Hospital (FSH) over one year. The results of this audit will guide referral pathways for ICH patients and assess the need for a neurosurgical service at FSH.Methods This audit included all patients presenting to FSH between 1/07/2021 and 30/06/2022 with a principal or secondary diagnosis of ICH. Ethics approval was obtained through the Governance Evidence Knowledge Outcome (GEKO) application portal. Collected variables included hospital identifiers, patient demographics, ICH characteristics, and patient outcomes.Results Of the 55 patients included, there was an overall mortality rate of 20% (n=11) across admissions in the acute stroke unit and rehabilitation centre. Functional independence at three months was achieved by 32.7% (n=18) of patients. A total of 7.3% (n=4) of patients admitted under the care of FSH were transferred to Sir Charles Gairdner Hospital (SCGH) for potential neurosurgical intervention, with a 25% intervention rate (n=1). Hydrocephalus was found to have a statistically significant correlation with neurosurgical transfer (Fisher’s exact test, p = 0.0118). Establishing a dedicated transfer pathway may reduce inter-hospital transfers and improve time to intervention for a subset of neurosurgical candidates at FSH. Notably, hydrocephalus is a key variable that could be included in the transfer pathway criteria.