Aims: There was no established consensus on the optimal blood pressure management protocol in patients with acute intracerebral hemorrhage (ICH). This study was to explore the association between blood pressure decreasing rates and survival time in patients with acute ICH. Methods: 786 acute ICH patients were enrolled in the study andhospitalized from 2004 to 2006. K-means clustering was used to classify the subjects according to the decreasing rates of blood pressure within 14 days of acute ICH patients. Cox regression was used to screen the independent influencing factors of 14-day survival in the univariate anaylsis among acute ICH patients. Results: There was significant difference in the decreasing rates of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in 1-2 d and 2-3 d after admission in patients with acute ICH (P < .05) between blood pressure decreasing stability and instability groups. The independent factors of 14-day survival in patients with acute ICH included: age, 24 h the National Institutes of Health Stroke Scale (NIHSS) score, bleeding volume, blood glucose, low density lipoprotein cholesterol, serum albumin, fasting, bleeding position and lowering rates of SBP (P < .05). And the risk of death within 14 days in the SBP decreasing instability group was 1.71 (1.02 to 2.86) times than those in stability group. Conclusion: Compared with DBP decreasing rates, SBP decreasing rates had a greater impact on the survival time in patients with acute ICH. In addition, patients with instable SBP decreasing rates had inferior survival than those with stable SBP decreasing rates.