Objective To investigate the differences in risk factors for cerebral hemorrhage between urban and rural areas in northern China to provide accurate prevention for cerebral hemorrhage in both urban and rural areas. Methods Data was collected from patients over 40 years old in different provinces in northern China, which was further divided into urban and rural groups. Condition matching method was used to analyze the risk factors and to compare these risk factors between urban and rural cerebral hemorrhage and. Results Data from 191,625 people were collected. Among 559 patients with cerebral hemorrhage, there were 251 and 308 patients in urban and rural areas, respectively Hypertension and lack of exercise had a stronger effect on cerebral hemorrhage in rural area [OR 95%CI (9.07,6.25～13.16)vs. (7.67,5.20～11.32)]、 [OR 95% CI (2.18,1.59～2.98)vs. (1.89,1.36～2.62)]. Family history of stroke, diabetes, and excessive overweight had bigger impacts on urban cerebral hemorrhage [OR 95%CI(5.40,3.48～8.36)vs.(5.09,3.37～7.68)]、[OR 95%CI(2.41,1.55～3.75)vs.(1.98,1.21～3.23)]、[OR 95%CI(2.38,1.69～3.35)vs.(1.71,1.26～2.32)]. Conclusions A more precise preventive measures can be developed based on the impact of different risk factors on urban and rural areas