Abstract Objective Past studies reveal that many patients with psychogenic non-epileptic seizures (PNES) also have a traumatic brain injury (TBI) history, but the specific influence of prior TBI on patients is presently under examination. This study aims to investigate the relationship between patients with PNES with a TBI history and symptoms/functioning, compared to those without a TBI history. Method Data collected from patients seen for comprehensive neuropsychiatric evaluation was analyzed, including TBI history, TBI severity, and Global Assessment of Functioning (GAF) scores. The GAF scale allows assignment of a numerical rating to patients based on their psychological and social functioning. Results Patients with PNES without TBI (n = 120; mean age 51) had higher average GAF scores (52.4) compared to those with TBI (n = 164, mean age 54, mean GAF 50) (p = 0.0059). Across PNES patients with a history of TBI, those with mild TBI exhibited notably lower GAF scores (43.2) than those with moderate (48.87) or severe (50) history of TBI. Conclusion Patients with PNES and a history of TBI had lower (worse) GAF scores than those without TBI, and worse in cases of mild TBI. Further exploration of demographic variables, education, and employment status will address potential confounds. Understanding the complex interplay between PNES and TBI may improve diagnosis and management strategies, with further research in advancing clinical practice.