Introduction: To investigate a more reasonable treatment strategy for traumatic brain injury in the critical surgery state and increase the clinical therapeutic effects. Methods: Fifty-nine patients with traumatic brain injury in the critical operation state were randomly divided into an experimental group (n = 31) and a control group (n = 28). Patient’s prognosis was compared between these two groups. Results: According to the Glasgow Outcome Scale scoring, 23 patients presented with low disability, 7 with moderate disability, 1 with severe disability, and no patients were in the persistent vegetative state or died in the experimental group; 14 patients presented with low disability, 8 with moderate disability, 3 with severe disability, 2 were in the vegetative state, and 1 died in the control group. Patient’s prognosis in the experimental group was significantly better than that in the control group (P < 0.05). Conclusion: The combined scoring system based on Glasgow Outcome Scale, intracranial pressure value and CT findings is of significance in the management of patients with traumatic brain injury in the critical surgery state.