Objective: To analyze the prognosis of 2 284 cases with acute traumatic brain injury and discuss possible methods to improve the outcome of head injuries. Methods: The relationship between trauma cause, trauma severity and management and patients outcome was retrospectively analyzed. Results: Good recovery was achieved in 60.20% , moderate disability was 13.22 %, severe disability 15.24 %, vegetative status 0.31 % and mortality 11.03 %. The mortality was 1.07 % in cases with GCS 15 13, 2.47 % in cases with GCS 12 9, 13.29 % in cases with GCS 8 6, and 57.4 % in cases with GCS 5 3. Conclusions: To prevent hypoxia, remove intracranial hematoma as soon as possible, use standard large traumatic craniotomy and apply mild hypothermia may be useful means for improving the outcome of severely head injured patients.