Society continues to pay a high price for the toll taken by head trauma. Attention must be paid to preventing these injuries, especially involving motor vehicle accidents and bicycle accidents. Current treatment of serious head injuries demands skilled airway management in the field; rapid transfer to Pediatric Trauma Centers; meticulous attention to oxygenation, ventilation, and systemic perfusion during the resuscitation phase; rapid identification and early surgical management of mass lesions; and aggressive control of intracranial pressure. Our hopes lie in better programs for prevention, improved understanding of the dynamics of the ongoing neurologic injury both at the organ system and cellular levels, and improved programs in neurorehabilitation.