Background: Penetrating head injuries, whether low or high velocity, are dreadful casualties associated with a high incidence of morbidity and mortality. Immediate radiological examination is mandatory to determine the extent of head penetration, location of the penetrating foreign body and need for surgical intervention. Objectives: This study aimedto evaluate the incidence of penetrating head injuries among polytraumatized patients and to follow up and determine the different outcomes of patients with penetrating head injuries. Patients and methods: This was a prospective observational descriptive study included 63 traumatic patients with penetrating head injury who were recruited over 1 year duration starting from November 2019 to October 2020 in Mansoura University Emergency Hospital and El-Sheikh Zayed Specialized Hospital, Egypt. Results: The mean age in the non-survived group was statistically significantly higher as compared to the survived group. The percentage of missiles (firearm) injuries in the non-survived group was statistically significantly higher as compared to the survived group. The Glasgow Coma Scale (GCS) on admission was statistically significantly lower in the non-survivor group as compared to the survivor group. The percentage of cases with unreactive pupils in the non-survivor group was statistically significantly higher as compared to the survival group. The incidence of subarachnoid hemorrhage, intracerebral hemorrhage and brain laceration was statistically significantly higher in the non-survivors group as compared with survivors group. The length of hospital stay and length of ICU stay were statistically significantly longer in the non-survivors. Conclusion: Early stabilization of patients with suspected head trauma. All patients with head trauma should undergo brain CT for early assessment of degree of brain affection.