Background: Incidence of trauma increased both in developing and developed countries especially in congested cities because of high traffic flow. This makes it a worldwide health and social issue. Furthermore, depressed skull fractures occur over venous sinuses in 11% –18% of cases, representing a fairly large proportion of these cases. Objective: To characterize the demographic, clinical and radiological findings of patients with depressed fractures overlying cranial dural sinuses that we have faced in our institute at Sohag University Hospital. Patients and Methods: This retrospective and prospective study was conducted on 50 patients with compound depressed fracture over venous sinuses, which were treated either surgically or conservative at Sohag University Hospitals. Results: Despite surgical group included patients with neurological deficit and impaired level of consciousness compared to conservative group; surgical group had the same outcome as the conservative group. CNS infection was not recorded in both groups and the superficial infection was significantly higher in the conservative group. Mortality related to the treatment modality was not recorded in our study. Conclusion: Both surgical and conservative treatment of compound depressed fracture over major cranial venous sinuses had a good outcome as regards morbidity and mortality. Risk of CNS infection is not high but surgical treatment can significantly decrease the risk of infection compared to the conservative treatment.