Objective To investigate the clinical value of compound ipratropium bromide atomization inhalation combined with ambroxol intravenous treatment in traumatic brain injury patients with tracheotomy. Methods Totally 58 elderly patients undergoing tracheotomy for traumatic brain injury admitted to our hospital from April 2014 to April 2015 were selected, and they were randomly divided into the observation group and the control group. The control group was treated with a pure ambroxol intravenous injection, and the observation group was treated with compound Ipratropium bromide atomization inhalation combined with Ambroxol intravenous treatment. Pulmonary infection time, the indwelling time for tracheotomy tube, the incidences of airway mucosal bleeding and other complications and the positive rate of sputum culture at 3, 7, 14 days after treatment were compared between the two groups. Results Pulmonary infection time and the indwelling time for tracheotomy tube were shorter in the observation group than in the control group 〔(16.8±7.2) d vs. (24.5±14.1) d, (19.0±5.9) d vs. (27.4±6.5) d, both P 0.05). The positive rate of sputum culture at 5 and 7 days after treatment were lower in the observation group than in the control group (48.3% vs. 55.2%, 34.5% vs. 51.7%, P<0.05). Conclusions The compound Ipratropium bromide atomization inhalation combined with Ambroxol intravenous treatment versus a pure Ambroxol intravenous treatment has a significant clinical efficacy in elderly traumatic brain injury patients with tracheotomy, and it can reduce the incidence of adverse reactions, which is worthy of clinical application. Key words: Cholinergic antagonists; Ambroxol; Craniocerebral trauma