Traumatic brain injury (TBI) is the most common cause of death and disability among children and young adults. TBI consists of both primary injury and a secondary injury resulting from hypoxia, arterial hypotension, and elevated intracranial pressure. Improved outcomes from pediatric TBI have resulted from improved primary recognition and treatment strategies. Treatment and assessment aimed specifically toward the immature brain can improve both functional outcome and long-term psychosocial impairment.