Background: Although reducing the burden of head injuries is an important focus of several injury prevention initiatives, they remain a large proportion of injury-related deaths. In New Zealand, trends over time and the socio-economic distribution of the cause-specific incidence of head injuries have received little attention. Methods: We analyzed primary hospitalizations (2000-2009) and deaths (1999-2008) due to head injury using national mortality and hospital discharge databases, specifically exploring variations in age-specific rates by major causes over time and by socio-economic deprivation. Population-based incidence rate estimates were calculated using census denominators. Results: Children aged <5 years and adults aged ≥65 years had the highest rates of hospitalization and mortality, respectively. Transport-related incidents and falls were the leading causes, with most fatal injuries occurring on roads and most hospitalized injuries occurring at home. There was a significant increase in mortality rates among older adults over the decade, and in most age groups, mortality rates increased with increasing levels of socio-economic deprivation. Conclusions: The findings of this review alongside the significant risks of premature death and disability reinforce the need to explore policies that address the specific causes as well as socio-economic inequalities in their distribution in New Zealand.