In the SWITCH trial, a closer examination of the outcomes reveals a shift in the mRS scores at 180 days, predominantly from modified Rankin scale (mRS) 6 to mRS 4, when decompressive craniotomy is added to the best medical treatment in patients with severe deep intracerebral hemorrhage. However, is moderately severe disability always preferable to death, and do the results unequivocally support the superiority of decompressive craniectomy in this setting?