Objective　To investigate the risk factors for early hematoma enlargement in hypertensive cerebral hemorrhage （HCH） and the clinical predictive value of （Glasgow Coma Scale） GCS score combined with blood glucose level at admission. Methods　A retrospective collection was performed on 106 HCH patients who were treated in the hospital from October 2014 to October 2018.According to presence or absence of hematoma enlargement showed by examination results of brain CT after admission，they were divided into enlargement group （29 cases） and non-enlargement group （77 cases）. The general data of the two groups were compared to analyze the risk factors for hematoma enlargement in early stage of hypertensive intracerebral hemorrhage. The receiver operating characteristic （ROC） curve was performed to analyze predictive value of GCS score combined with blood glucose level at admission for early hematoma enlargement in HCH. Results　There were no significant differences in gender，age，hematoma location，diastolic blood pressure at admission or long-term smoking history between the two groups （P>0.05）. There were significant differences in GCS score，systolic blood pressure at admission，fasting blood glucose，hematoma morphology and long-term drinking history at admission （P<0.05）. The results of multivariate Logistic regression analysis showed that low GCS score，high admission systolic blood pressure，high fasting blood glucose，hematoma irregularity and long-term drinking history at admission were independent risk factors influencing early hematoma enlargement in HCH patients （P<0.05）. The areas under ROC curve （AUC） of GCS score and blood glucose level at admission for predicting early hematoma enlargement of HCH 0875 and 0.819，respectively，significantly lower than that of their combination prediction （0.886，P<0.05）. Conclusion　Low GCS score，high systolic blood pressure at admission，high fasting blood glucose，hematoma irregularity and long-term drinking history at admission are independent risk factors influencing early hematoma enlargement in HCH patients. GCS score combined with blood glucose level at admission is of relatively higher clinical value for predicting early hematoma enlargement in HCH.