Objective: The influence of oestrogen and testosterone replacement on stroke risk has been examined, as well as mechanisms by which oestrogen may protect from post-stroke damage. However,, whether testosterone levels in the early time period after haemorrhagic stroke influence long-term mortality has not previously been investigated. We examined whether these concentrations were predictive of risk of death. Setting: University hospital. Design: Prospective study. Main measures: Testosterone and oestrogen levels in the week after haemorrhagic stroke were measured, and the predictive value of these levels and other clinical parameters such as the size, location and severity of the stroke on mortality during the three-year length of the study were assessed. Results: Glasgow Coma Scale and low testosterone/oestradiol ratio on post-stroke day 7 were independent predictors of mortality. Stroke location and hematoma volume had no predictive power. Conclusion: The testosterone/oestradiol ratio on day 7 after a haemorrhagic stroke is an independent predictor of mortality during later months.