Objective: To investigate the posture management of patients with hypertensive intracerebral hemorrhage based on cerebral blood flow monitoring. Methods: A total of 80 patients with hypertensive intracerebral hemorrhage, who admitted to the Affiliated Hospital of Yangzhou University from August 2017 to May 2019, were included in the study. Under the monitoring of transcranial Doppler (TCD) cerebral blood flow, the patients were managed in position, with the head elevation angle (0°, 15°, 30°, 45°) gradually being changed. The changes of intracranial pressure (ICP), cerebral perfusion pressure (CPP) and vital signs in different positions were observed and compared. Results: 1) The ICP and CPP levels of 15° and 30° head up were significantly lower than those of 0° head up, while the ICP and CPP levels of 45° head up were significantly higher than those of 0° head up (P<0.05); 2) There was no statistically significant difference in heart rate (HR), systolic pressure (SP), diastolic pressure (DP), mean arterial pressure (MAP), and pulse oximetry saturation (SpO2) levels among patients with different bed elevation angles (P>0.05). Conclusion: TCD is a feasible and effective method to accurately monitor ICP and CPP in patients with cerebral hemorrhage. The intervention of elevated 15°~30° positions for postoperative patients with hypertensive intracerebral hemorrhage can significantly reduce the CPP and ICP, decrease the incidence of secondary brain injury, so that the patients can obtain the best nursing effect. It is worth being widely promoted in clinical practice.