Objective: to evaluate the informative value of serum concentration of matrix metalloproteinase (MMP)-9 within the determination of the short-term prognosis in patients in the acute period of spontaneous supratentorial intracerebral hemorrhage (SSIСH) on the ground of conservative treatment. Materials and methods. A prospective, cohort, comparative study was conducted in 105 patients in the acute period of SSICH on the ground of conservative treatment. The level of neurological deficit was assessed using of the Full Outline of Unresponsiveness Coma Scale, the Glasgow Coma Scale, and the National Institutes of Health Stroke Scale. The visualization of cerebral structures was performed by computed tomography. On the 1st and 5th day from the admission, laboratory blood samples were taken and then serum concentrations of MMP-9 were determined by enzyme-linked immunosorbent assay. Early neurological deterioration and unfavorable outcome of the acute period of SSICH (modified Rankin scale grade 4–6 on the 21st day of the disease) were registered as combined clinical endpoints. Statistical processing of the results was carried out with the help of correlation analysis, logistic regression analysis, ROC-analysis. Results. Patients with unfavorable clinical course and unfavorable outcome of the acute period of SSICH had a higher serum concentration of MMP-9 on the 1st day from the admission, and this marker was directly correlated with the secondary intraventricular hemorrhage volume (R=0.40, p<0.01) and total volume of intracranial hemorrhage (R=0.29, p<0.01). It was determined that the assessment of serum MMP-9 concentration along with neuroimaging indicators (midline shift severity, secondary intraventricular hemorrhage volume) as part of the developed multi-predictor logistic regression model allows to verify individual risk of early neurological deterioration (AUC±SE (95% confidence interval)=0.93±0.03 (0.86–0.97), p<0.0001). Conclusion. Serum MMP-9 levels in patients with SSICH on the 1st day from admission is an informative additional parameter for prediction of early neurological deterioration on the ground of conservative treatment.