Background: Traumatic Brain injuries (TBI) are a real social problem with an upward trend worldwide. For these reason prognostic factors in head injury are of major importance to all surgeons who treat patients with severe head injury especially for countries like India for better targeting of limited health care resources and implementation of specific methods of treatment to patients and to determine the incidence of age, sex, distribution, etiological factors, clinical presentation, neurologically assessment and mode of head injuries with particular reference to severe head injury. Methods: This study was conducted in the Neurosurgery unit of Surgery department of Index Medical College, Hospital & Research Centre, Indore from Jan 2016 to Jun 2017. In this study 150 patients of severe head injury were included These patients were evaluated for the severity of the head injury (GCS), clinical presentation, X-rays, C T scan/MRI, early complication (Hypoxia and Hypotension) and Post traumatic seizures. Result: In all 150 patients with severe head injury were identified shows that road traffic accident is the main cause of head injury in majority of cases with male preponderance. Incidence of head injury due to fall from height was nearly equal in both sex. It was found that maximum number of head injury patients belonged to the age group of 21-40 years (78%) in male. Maximum number of head injury was caused due to road traffic accidents (72%). Conclusion: Males are more prone to head injury due to road traffic accident with maximum in two –wheeler accidents as most of the patients were not wearing helmets. CSF otorrhoea was more common than CSF rhinorrhoea. Extradural hematoma was more common in tempero-parietal region and Coup injuries were more common than contre coup injuries. Types of trauma and brain lesion, hypoxia and hypotension, hyperglycemia and early post traumatic seizures are the important prognostic factors.