Background: Traumatic brain injury (TBI) is considered an important worldwide public health epidemic, economic and social issue affecting all societies.
Objectives: To assess & determine the efficacy and safety of atypical antipsychotics (Risperidone & Quetiapine) in the management of agitated behaviors following moderate TBI.  
Patients and methods: prospective randomized controlled study conducted among 60 adult patients with TBI admitted to the trauma ICU department of Minya University Hospital (MUH) during the study period which starts on July 15, 2022. 60 patients were randomly allocated into one of three groups: Risperidone group received (0.5 mg up to 2 mg once daily), Quetiapine group received (25 mg up to 100 mg once daily) and control group. All patients received conventional treatment.
Results: The current study reveals there was insignificant difference among the three groups as regard CT brain findings also, there is a significant difference among the three groups as regard the control of agitated behaviors following TBI. Regarding Richmond Agitation Sedation Scale (RASS score) at day risperidone group revealed significantly decreased from day 3^rd to day 9^th than quetiapine group (p< 0.05). Also, RASS at night, risperidone group show significantly decrease from day 2^nd to day 9^th (p< 0.05).
Conclusions: The current study established the superiority of Risperidone over Quetiapine in the management of agitated behaviors following TBI.