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Hematoma expansion is a known predictor of poor clinical outcome in patients who suffered a spontaneous intracerebral hemorrhage (ICH). A spot sign seen on computed tomography (CT) angiography (CTA) and/or an island sign seen on noncontrast CT of the head have the potential to serve as an indicator for hematoma expansion. This current report describes the case of a 43-year-old man who presented with right-sided weakness and aphasia due to a left-sided basal ganglia ICH. CTA of the head demonstrated a crescent-shaped enhancement at the periphery of the bleed (crescent sign), which was associated with hematoma expansion.