Outcome from acute subdural hematoma has been very poor. This study included 42 adults with traumatic acute subdural hematoma (ASDH). They constituted 5% of all adults with head injuries required hospital admission during the period between 1999 and 200 l. Male to female ratio was 4.3 : I. Age of the patients ranged between 21 years and 69 years with an average age of 34 years. They were treated either surgically (I8 patients) or conservatively (24 patients). Criteria for surgery were primarily based upon the clinical status of the patients on admission and CT scan findings. The overall mortality was 59.5%. Evaluation of the final outcome of survivals during 6 months after injury according to Glasgow outcome scale (GOS) [9] showed that, the final outcome was influenced by age of patient, post-resuscitation Glasgow coma scale (GCS) and associated intracranial injuries, as younger patients, higher post-resuscitation GCS and ASDH without associated intracranial injuries carry a better prognosis and outcome.