Objective To discuss the clinical application of multi-slice spiral CT angiography (MSCTA) in acute spontaneous intracranial hemorrhage .Methods 41 cases of acute spontaneous intracranial hemorrhage diagnosed with CT (including subarachniod cavity hemorrhage 29, intra-cerebral hematomas 12)were examined with MSCTA,the techniques of volume rendring (VR) and maximum intensity projection(MIP)were used. 7 cases of intracranial aneurysm closed by titanic clamp , 2 cases of cerebral arteriovenous malformation(AVM) and one case of AVM treated by intra-zest aneurysm excision,the post-operative MSCTA examination were received.Results 11 cases of intra-cerebral aneurysm, 4 cases of cerebral AVM and 1 case of AVM with intra-zest aneurysm were found among the 41 cases of acute spontaneous intracranial hemorrhage. MSCTA clearly demonstrated the size,neck and artery of aneurysms as well as the location, size ,zest shape, artery and vein of AVM. Pre-operative MSCTA findings of 7 cases of intracranial aneurysm clapped by titanic clap ,2 cases of cerebral AVM and 1 case of AVM treated by intra-zest aneurysm excision were confirmed with the operative findings.Post-operative MSCTA showed that the clamp location was normal; arteries were passable; zests of AVM were excised. Conclusion MSCTA is a non-injured, rapid and effective way to find the cause of acute spontaneous intracranial hemorrhage.It also has clinical application of post-operatiove assessment for intracranial aneurysm and cerebral AVM.