Background and Purpose: To evaluate risk factors for intracerebral hemorrhages and the clinical effects of these hemorrhages in patients treated with recombinant tissue plasminogen activator (rt-PA) for acute stroke. Methods: In this prospective analysis, data were collected for patients with acute anterior circulation stroke who received intravenous (I V) rt-PA within 4.5 hours of symptom onset, after computed tomography (CT) between December 2008 and July 2013. Copies of head CT scans were obtained 24 hours after starting tr eatment. Intracerebral hemorrhages were classified according to the European-Australasian Acute Stroke Study (ECASS) classification. The definition of Safe Implementation of Thro mbolysis in Stroke (SITS) was used for symptomatic intracerebral hemorrhage (sICH). Th e clinical outcomes of the patients were determined using the modified Rankin scale (mRS) at 90 days after treatment. Results: Asymptomatic intracerebral hemorrhage (aICH) was observed in 50 (22.6%) of 221 patients and symptomatic intr acerebral hemorrhage (sICH) was observed in 9 (4.1%). Multivariate analysis showed that the baselin e glucose level and Alberta Stroke Program Early CT (ASPECT) score were associated with sICH. However, only the baseline ASPECT score was related to aICH. Patients with sICH and aICH both had higher mRS scores and mortality rates at 90 days compared with those without. Conclusions: The presence of early ischemic changes on CT and hyperglycemia at the time of admission are independent ri sk factors for sICH in patients treated with IV rt-PA. Therefore, care must be taken in the evaluation and management of these factors.