Background: Several literatures supported that trauma complicates 6-7% of all pregnancies. Despite the rapid progressiveness of traumatic brain injury (TBI) worldwide, there is paucity in literatures regarding the exact incidence of TBI in pregnancy. Management poses a great challenge; the anatomical and physiologic maternal changes due to pregnancy, added to the consideration of existence of two lives till the end. Objective: To increase the awareness about the management of pregnancy in cases presented with traumatic brain injury during pregnancy. Case report: We described the management and follow up of a case of 30 years old multiparous female who presented in Sharm International Hospital, on 25-8-2019, at 18weeks gestation, post Road Traffic Accident (RTA) with Glasgow Coma Scale (GCS); 9T (eye opening, localize pain and endotracheal intubated).She was referred from nearby hospital (El Toor General Hospital) with endotracheal tube fixed since about 3 weeks, for tracheostomy and management. The patient was admitted to ICU with file No: 3384, on 25-8-2019. The patient was very carefully managed in the intensive care unit (I.C.U.) in Sharm International Hospital up to successful vaginal delivery of a live female weighed 1500 grams, at +/-30 weeks gestation. As the mother was severely ill and the fetus was extremely premature, we preferred the vaginal mode of delivery which we supposed to be less risky for the mother. The Marvelous baby was handled by pediatrtion team and neonatology doctor. After 3 weeks the baby went home with good crying and on bottle feeding. Unfortunately the mother died 10 days after labor.