目的　探讨原发性延髓出血 (PMH)的临床特点。方法　报道 3例 PMH的临床和影像学特点并复习有关文献。结果　 PMH临床甚罕见 ,以后组颅神经下运动神经元瘫痪、小脑征、传导束征为主要表现。临床上易误诊。确诊有赖于 MRI检查。结论　随颅脑影像学技术的发展 ,轻型 PMH可得以早期确诊。 Objective To investigate the clinical features of primary bulbar hemorrhage (PMH). Methods The clinical and imaging features of 3 cases of PMH were reported and reviewed. Results The clinical manifestations of PMH were rare. After the cranial nerves, the motor neurons were paralyzed, the signs of the cerebellum and the signs of conduction were the main manifestations. Clinically easy to misdiagnosis. Diagnosis depends on MRI examination. Conclusion With the development of craniocerebral imaging technology, light PMH can be diagnosed early.