Cranioplasty performed after a decompressive craniectomy (DC) for traumatic brain injury (TBI) , stroke or aneurysmal bleed has a role of restoring cerebral protection and craniofacial cosmesis as well as improving neuromotor function [1] . There has been no consensus with regards to ideal timing of cranioplasty(CP) after DC. METHODOLOGYA retrospective cohort study was carried out at a tertiary care hospital on patients undergone early (less than or equal to12 weeks) and late (greater than 12 weeks) cranioplasty using autologous cranial bone after DC. The functional independence measure (FIM) tools were used to compare neuromotor & cognitive function outcome between the two groups. Appropriate statistical tools were used to compare neuromotor and cognitive function improvement as well as complication rates between early and late cranioplasty. RESULTS31 adult patients of Cranioplasty (21 male and 10 female) were evaluated. 16 undergone early and 15 late cranioplasty. Comparison for neuromotor and cognitive function using FIM tools revealed statistically significant neuromotor & cognitive advantage in the early cranioplasty group. Overall complication rates between the two groups varied but were statistically insignificant. DISCUSSION& CONCLUSIONPerforming an early cranioplasty provides advantages of improvement of neuromotor and cognitive function through early restoration of cerebrospinal fluid and intra cerebral hemo-dynamics. It further avoids the potential problems of developing the ‘syndrome of trephined’ and resorption of the autologous bone.