Head trauma is one of common injury related mortality and morbidity. Blood biomarkers are valuable tools for the identification and characterization of initial injury and secondary pathological processes for traumatic brain injury (TBI). This study evaluated the performance of a recently developed visfatin and its genetic marker and its correlation with other blood circulating biomarkers that reflect specific pathological mechanisms including neuro inflammation, neuron injury and oxidative damage in moderate to severe TBI patients. Peripheral blood was taken from TBI patients (n=78) at hospital admission, maximum 6 hours post-injury. Severity and neurological outcome were assessed using the extended Glasgow Coma Scale (GCS) and blood level of: visfatin and its gene, neuron specific enolase (NSE), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH). Concentrations of visfatin, NSE and MDA were significantly higher in TBI patients compared to control group, while SOD and GSH were decreased in TBI patients compared to control group. Visfatin was positively correlated with NSE and MDA, while there was negative correlation with SOD and GSH. Regarding visfatin genotype, CC genotype had the highest plasma concentrations of visfatin, NSE and MDA and lowest concentrations of SOD and GSH. These concentrations did not significantly differ between the variant genotypes CT and TT. In conclusion blood level of visfatin and its genetic marker in correlation with other blood biomarkers can be used for prediction of severity of TBI cases.