Background: Traumatic brain injury (TBI) is the most leading cause of mortality and disability worldwide, with long-term complication. Implementing initial neuro-protective nursing care could improve the results for TBI patients. Aim: The study aimed to assess the effect of implementing initial neuroprotective nursing care on outcomes of TBI patients. Method: This study was carried out at the emergency department of the Emergency Hospital, Mansoura University, using a quasi-experimental research method. 78 patients composed of a convenience sample, 39 of whom were in the study group and 39 of whom were in the control group, of both genders who aged more than or equal 18 years, and admitted to the previously setting were included. Data was gathered using a single tool of initial traumatic brain injury patients' assessment tool. Results: it revealed a significant improvement in the GCS of the study group (8.48± 1.50) after the implementation of the intervention than that of the control group (7.35±1.47) also there was a statistically significant differences between both studied TBI groups post-intervention as regards pupil equality (P <0.001), pupil size (P =0.026), and the pupil reaction to light (P<0.001) and all physiological parameters (P≤0.001). Recommendations: It is recommended to integrate initial neuro-protective nursing care on the emergent care of TBI patient. Additionally, evaluation of the long-term effects on TBI patients in varied contexts of the initial neuro-protective nursing care.