The management of patients with severe head injury continues to present neurosurgeons with a major challenge. Despite of early diagnosis and aggressive treatment, it has showed still high mortality and morbidity. We analyzed the results of treatment of 50 cases with severly head injured-children who were treated during past 2 years for detection of predicting factors of outcome. Our conclusions are as follows ; 1) The Glasgow coma scale(GCS) on admission was an important predicting factor for outcome of severe head injury. In patients with 3, 4 of GCS, outcome was poor. In cases above 5 of GCS, outcome was better than the former. 2) The clinical features on admission(i. e., light reflex of pupils, oculocephalic responses and abnormal motor responses) were also important predicting factor of outcome. 3) There was no significant relation between outcome of severe head injury and age distribution in children. 4) The mass lesion occupied relatively small proportion in the types of lesion which was proved by CT scan(26%). 5) Overall outcome showed 28% of good recovery, 26% of moderately disabled, 12% of severly disabled, 12% of vegetative state and 22% of dead.