Objective To explore the evaluated value of CT angiography (CTA) dot signs on the prognosis in patients with early cerebral hemorrhage. Methods The clinical data of 48 patients with early cerebral hemorrhage admitted to our hospital from July 2016 to July 2018 were retrospectively analyzed. The patients were given emergency CT plain scan and CTA examination within 6 h after onset, and 48 patients were divided into two groups according to whether there were any dot signs in the original CTA images. If the patient' s condition deteriorated, CT would be reviewed in time or review was given at 24 h after onset. The amount of hematoma was calculated, and the changes of hematoma volume at initial visit and return visit were compared between the two groups, and the predictive value of CTA dot signs on hematoma enlargement was evaluated. Results Among the 48 patients, 12 cases (25.00%) were with positive dot signs and 36 cases (75.00%) were with negative dot signs. The hematoma volume at return visit in patients with positive dot signs was significantly higher than that at initial visit, and was significantly higher than that in patients with negative dot signs (P<0.05), and there was no significant difference in the hematoma volume between initial visit and return visit in patients with negative dot signs (P>0.05). The sensitivity, specificity, accuracy rate, positive predictive value and negative predictive value of CTA dot signs in predicting hematoma enlargement were 73.33% (11/15), 96.97% (32/33), 89.58% (43/48), 91.67% (11/12) and 88.89% (32/36). Conclusion CTA dot signs can provide objective imaging indicators for the prognosis of patients with early cerebral hemorrhage. And it has high accuracy in the prediction of hematoma enlargement, and it is helpful for screening high-risk patients who may be with hematoma enlargement, so that these patients can be treated more timely and accurately.