Aim: To evaluate external ventriculostomy and intraventricular instillation of recombinant tissue plasminogen activator for management of spontaneous intra-ventricular hemorrhage. Material and method:The present non-randomized prospective study was done in the Department of Neurosurgery among 30 patients who underwent external ventriculostomy and intraventricular instillation of recombinant tissue plasminogen activator at Bangur Institute Of Neurosciences & SSKM HOSPITAL, IPGME&R, KOLKATA between April 2020 – August 2021. Various parameters studied were GOSE SCORE: 7 days------>30days------>90 days, Ventriculitis: (0-180days) (y/n), 30 days survival (y/n), worsening hemorrhage during t/t till 72 hr. of last dose (y/n), worsening hemorrhage during t/t > 72 hr. of last dose (y/n), hydrocephalus during follow up (y/n) and Qol (EQ5D) at 1 month and 3 months