The study was designed to analyze the demographic data of victims with fatal head injuries and forensic evaluation of these injuries with recording some patterns, shapes and causes of fatal head injuries. This study included victims of fatal head injuries, which were autopsied at Qena governorate over a period of five years from the 1st of January 2011 to 31st December 2015. Data were collected from autopsy reports in Qena forensic department of ministry of justice archives. This study included 149 victims. The majority 130 cases were males while only 19 victims were females. Manner of death was homicidal in most cases (66.4%). The highest number of cases occurred in Dishna division (39 cases). The overall incidence of head injuries in Qena governorate was 4.7 per 100000 inhabitants. The highest number of cases occurred in summer (45 cases). May and July (22 cases each) were the most frequent. The most common causative instrument among the examined cases was the assault rifle (95 cases). Most victims (71.8%) died immediately after head injuries. Brain hemorrhages were found in all the studied victims. Contusions and lacerations were frequently presented. Death occurred immediately in most cases of brain laceration and contusion. In conclusion there were a high number of head injuries in Qena governorate during the duration covered by the study. Most of them were males. Injuries were more common during summer with highest incidence in Dishna division. The assault rifle was the weapon of choice. Most cases died immediately due to skull fractures, brain hemorrhages, contusions and lacerations.