Objective To investigate the dynamic changes in plasma CXCL12 level and their influence on prognosis in patients with acute hypertensive intracerebral hemorrhage (AHIH), as well as the correlation between plasma CXCL12 level and relative edema volume.Methods A total of 34 patients with AHIH were enrolled and ELISA was used to measure plasma CXCL12 level within 24 hours and at 3, 7, and 14 days after onset. A total of 25 healthy subjects who underwent physical examination were enrolled as control group. According to modified Rankin Scale (mRS) score, the patients with AHIH were divided into good outcome group (mRS≤2) and poor outcome group (mRS>2). Relative edema volume was calculated based on cranial CT results within 24 hours and at 3 and 7 days after onset.Results The AHIH group had a significantly higher plasma CXCL12 level within 24 hours than the control group (19.85±1.84 μg/L vs 11.34±2.23 μg/L, P<0.01). The AHIH group had a rapid increase in plasma CXCL12 level at 3 days after onset (22.56±1.56 μg/L), a peak plasma CXCL12 level at 7 days after onset (23.38±1.53 μg/L), and a reduction in plasma CXCL12 level at 14 days after onset (22.64±1.78 μg/L). The good outcome group followed this trend, while the poor outcome group had no reduction in plasma CXCL12 level at 14 days. There were significant differences in plasma CXCL12 level at 7 and 14 days between the two groups (P<0.05 and P<0.01). Pearson correlation analysis showed that at 3 and 7 days, plasma CXCL12 level was positively correlated with relative edema volume (r=0.631, P<0.01; r=0.435, P<0.05).Conclusions There is a significant increase in plasma CXCL12 level after intracerebral hemorrhage, and patients with a continuous increase in plasma CXCL12 level tend to have poor prognosis. Dynamic monitoring of plasma CXCL12 level can provide a basis for the assessment and treatment of cerebral edema.