Background: The basic aims of transcranial ultrasound-based intracranial pressure monitoring are to help doctors maintain optimal brain perfusion and oxygenation while also preventing surgical and medical issues. Transcranial Doppler ultrasonography (TCD) provides a non-invasive evaluation of cerebral blood flow (CBF) or velocity. Objective: Measuring cerebral blood flow velocity in the main intracranial vessels non-invasively and with high diagnostic accuracy by using TCD. Patients and Methods: 60 patients with traumatic brain injury (TBI) had been treated at Emergency Department (ED). In the first six hours following trauma, TCD ultrasonography was carried out as soon as breathing and hemodynamic stability were achieved. S probe was used for the examination, and the Phillips Affinity G 50 gadget was used. The trans temporal window, or temporal region just above the zygomatic arch, was covered by an ultrasound transducer. Results: The range of age of our patients varied from 18 to 66 years with an average of 38 ± 13.76. TCD parameters were normal in 47(78.3%) while abnormal findings were recorded in 13(21.7%) patients. Hypoperfusion was detected in 9(15%) and 4(6.6%) patients showed vasospasm. Patients with normal TCD parameters had less days of mechanical ventilation and duration of hospital stay than the patients diagnosed with hypoperfusion or vasospasm by TCD, with P value <0.001. Pulsatility index (PI) showed sensitivity of 81.82%, specificity of 81.63%, PPV of 50.0% and NPV of 95.2%. Conclusion: With great diagnostic accuracy, the TCD can non-invasively monitor the CBF velocity in the major intracranial vessels.