Objective: Despite the increase in the elderly population, little research has been done regarding the factors than predict mortality in traumatic brain injury in older patients. The purpose of this study is to identify gactors that might relate to the mortality in such population group. Methods: The medical records of 39 patients older than 65 years who died after operation following traumatic brair injury from January 2001 to December 2005 were reviewed. Variables studied included age, sex, systolic blood pressure after operation, mechanism of injury, Glasgow coma scale (GCS), pre-existing illness, complications, and cause of death. Results; There were 30 men and 9 woman with a mean age of 72.4 years (range 65~89 years). Of the injury mechanisms, pedestrian injuries were more common (43.6%). Among the 39 cases of death, 28(71.8%) died of cardiac arrest immediately after operation. Glasgow coma scals (GCS) and postoperative hypotension were statistically significant factors related to death following operation. Conclusion: Surgical outcome is unexceptionally poor in the elderly head-injured patients, especially in those patients who had GCS 8 or below, the presence of significant midline shift on CT scan, and unilaterally or bilaterally dilated pupil. Even in dild or moderate injury, it is difficult to return home without and deficit. Early identification of the progression and aggravation to irreversible condition and aggressive management may be needed to decrease in rate of morbidity and mortality in the elderly. It is essential to treat carefully about the intracranial and general factors which influence survival and outcome.