Spontaneous intracerebral hemorrhage (ICH) is a common condition that often leads to death or disability. Accurate prediction of the outcome and decisions regarding the treatment of ICH patients are important issues. We report a case of thalamic hemorrhage with an intraventricular hemorrhage that was suddenly migrated into the third and fourth ventricles in its entirety 8 hours after symptom onset. To our knowledge, this case is the first report of spontaneous migration of thalamic ICH into ventricles, and we suggest a possible mechanism for this case with a brief review of the literature.