Spontaneous intracerebral hemorrhage (SICH) is a fatal subtype of stroke, closely associated with multiple risk factors, particularly metabolic abnormalities. In recent years, the triglyceride-glucose (TyG) index has emerged as a novel biomarker for metabolic syndrome, attracting growing attention from both the clinical and research communities. The TyG index is calculated based on triglyceride and fasting glucose levels and has been demonstrated to be closely related to insulin resistance, inflammatory responses, and cardiovascular diseases. This review aims to explore the potential association between the TyG index and SICH and to analyze its value in the early prediction of intracerebral hemorrhage. First, we provide an overview of the pathological mechanisms underlying SICH, with a focus on the roles of hypertension, vascular pathological changes, and metabolic dysregulation in its occurrence. Second, we examine the biological significance of the TyG index in metabolic abnormalities, insulin resistance, and lipid metabolism disorders, particularly its predictive role in cardiovascular and cerebrovascular diseases. Lastly, we discuss the clinical application of the TyG index in the early prediction of SICH, emphasizing its advantages as a simple, cost-effective, and easily implementable screening tool that can aid clinicians in identifying and intervening in high-risk populations. This article aims to review the association between the TyG index and intracerebral hemorrhage.