Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in children over the age of 1 year worldwide and poses significant burden to children and families. While our understanding of the pathophysiology of paediatric traumatic brain injury continues to grow, little headway has been made in evidence-based treatments which yield improvement in outcome. This chapter aims to give the reader a greater understanding of the epidemiology and basic concepts of TBI management, alongside the pathophysiology of secondary injury and practical monitoring and management strategies currently used within paediatric intensive care.