Background: Head injuries (HI) are major threat to public health; they are significant risk factors for mortality in all age groups of population around the world. Head injury has impacted the countries ' economies causing some financial losses, and reduced productivity. Aim: The purpose of this study was to assess pattern, occurrence mode, severity, associated factors and outcome of traumatic head injuries in Menoufia University Hospital. Subjects and methods: This was a cross sectional prospective study of 423 cases of traumatic head injury (THI) attended to Menoufia University Hospital over one year from 1st of January 2019 to the end of December 2019. Data about patient demographics, cause of injury, the instruments used, site, type of skull fractures or hemorrhage if present were gathered. Head injury severity was assessed by using the Glasgow Coma Scale (GCS) and outcome at time of discharge was documented. Results: Total 423 cases of traumatic head injury that met the inclusion criteria. 31% were in age between (30- <45y), (25%) in age from (15- <30y). Males approximately were three times more than females. Cases from rural areas represented (59.6%) versus (40.4%) from urban areas. Laborer followed by student were the mostly affected categories (49.5 %). The commonest cause was road traffic accidents (RTA) in 50.8%. Blunt instrument was frequently used agent (91%), while the most frequent site affected in skull was the more than one site in (30.3%). Skull fracture was the most common finding in computed tomography (CT) (31.7%). According to GCS, Mild cases (13-15) predominant than other degrees of coma representing 84.4%. The most common outcome was complete recovery (89.6%). highly significant relation was found between outcome and GCS. Conclusion: Traumatic injury to the head is a common injury among emergency unites' cases. The total number of cases was 423. The majority of cases were males. The age group most commonly affected was between (30-<45y). Rural cases outnumbered those from urban areas. The most affected categories were laborer and student. RTA was the most common cause of traumatic head followed by assault. Intracranial hemorrhage and skull fractures are common association with THI.