Objective: The study aims to analyze the impact of different factors associated with severe traumatic head injury having Glasgow coma scale score (GCS?8) and their impact on the outcome of patients. 

Methods: The prospective study was conducted at the Department of Neurosurgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India from December 2020–Dec ember 2022. The study enrolled 280 cases who met the inclusion criteria and they were managed as per standard protocol. They were assessed by GCS score, mode of injury, compute tomography (CT) scan findings, and various other parameters. The outcome of cases were measured by Glasgow outcome score (GOS). 

Results: Among the total 280 participants, 184 (65.7%) were males, while the remaining 96 (34.3%) were females. 162 patients of severe traumatic brain injury were operated, whereas the remaining 118 patients were managed conservatively. Road traffic accidents (RTA) was the leading cause of death (n=218, 77.9%) followed by fall from the height (n=28, 10%). Majority of the patients (n=151, 53.9%) presented to the emergency within 6-12 hours after injury whereas 18.2% of the cases presented 12 hours after the injury. The mortality was 55%, followed by persistent vegetative state (5.7%), severe disability (13.6%), moderate disability (20%) , and 5.7% achieved a good recovery thereby regaining  their pre-injury level of functioning. 

Conclusion: The patients with severe traumatic brain injury had a poor outcome. The outcome can further be improved by timely surgical intervention and by improving the prehospital care to the injured patients