Abstract: Objective:To summarize the experiences of early ultra low craniotomy decompression operation on severe craniocerebral injury.Methods:With the pterional approach for the foundation,expanding the operation range to prefrontal parietal and temporal cortices according to the injury lesions need,releasing skull base vacuum space,and preventing vicious cycle of intracranial pressure asearly as possible.Results:According to Glasgow healing standard evaluation the results showed good in 22 cases moderate disability in 9 cases,plant survival in 5 cases,14 cases were died,the mortality was 28%.Two of them were died of combined injury,3 patients were died of giving up treatment,3 patients were died of uncontrollable malignant intracranial hypertension,4 patients were died of pulmonary infection,1 patient was died of stress ulcer,1 patient was died of internal environment disturbance.Conclusions:Ultra low craniectomy decompression is an ideal method which can prevent vicious spiral of intracranial pressure early with sufficient and effective decompression.