Background: Traumatic brain injury (TBI) is a critical public health and socioeconomic problem throughout the world, making epidemiological monitoring of incidence, prevalence and outcome of TBI necessary. In addition, TBI in elderly patients is a neglected global disease burden. The main cause is fall, followed by motor vehicle accidents. Severe trauma in elderly population imposes a significant health care burden and is associated with substantial morbidity and mortality. Objective: To determine the pattern and outcome of traumatic brain injury in geriatric population in order to improve the management of geriatric trauma patients at Emergency Hospital Mansoura University. Patients and methods: This was a prospective observational clinical study, which was conducted on 206 elderly trauma patients presented and admitted to Emergency Hospital Mansoura University (a level one trauma center with about 250,000 visit and 25,000 trauma cases per year) over a year from December 2019 to December 2020. Results: Polytrauma was the commonest type with only 35% of the studied cases were isolated head injury. Most cases had multiple lesions (63.6%) with only 36.4% of which had single lesion. The majority of cases had no associated injuries, with few cases had scalp injury (16.5%) and free abdominal fluid of various degrees (27%). The average period of hospital stay was 10.42 ± 3.110, while the average period of ICU stay was 7.75 ± 4.538. The average GOS among the studied cases was 4.83 ± 2.965 and the majority of which (359%) died (grade 5). Conclusion: The current study demonstrated that, TBI in elderly cases is a life threatening condition with a high mortality rate in which falling from height (FFH) was the predominant mode.