Could corticosteroids impact outcomes in traumatic brain injury? This large, multicenter, randomized, placebo-controlled trial investigated the effect of intravenous corticosteroids on mortality in patients with clinically significant head injuries. A total of 10,008 adults were enrolled, with the intervention group receiving corticosteroids and the control group receiving placebo. The study revealed that methylprednisolone administration within 8 h of traumatic brain injury could lead to possible harm with higher mortality at 2 weeks and 6 months and more severe disability among survivors. These findings led to a change in practice, with corticosteroid therapy being largely abandoned for the management of severe head trauma. The trial emphasized the importance of evidence-based interventions in trauma care, revealing that corticosteroids were not beneficial and could be harmful in this context.