Small cell lung cancer metastasized to the brain with brain stem hemorrhage requires perfect examination to clarify the hemorrhage, immediate treatment such as lowering intracranial pressure and anti-epilepsy, and surgery if necessary. In patients with lung cancer brain metastases, headache, vomiting, epilepsy, hemiparesis of limbs, aphasia and visual field defects will suddenly appear after brain stem hemorrhage. The treatment of brain stem hemorrhage must be timely. At this time, it is necessary to clarify the hemorrhage of brain metastasis and whether there is intracranial hypertension through CT or magnetic resonance, and then immediately carry out the treatment of mannitol dehydration, hemostasis, observing the patient’s vital signs, and choosing whether it is necessary to do the surgery of removing intracranial hematoma or not. When brain metastasis of small cell lung cancer occurs and brain stem hemorrhage occurs, observe the vital signs closely and consult neurosurgery department of regular hospital for treatment.