Traumatic brain injury (TBI) remains a leading cause of mortality and disability worldwide. Surgical intervention is one of the main pillars of TBI management. The mainstay of treatment for substantial intracranial hematomas is surgical evacuation. In addition, patients with TBI may have brain swelling and increased intracranial pressure. If the latter is refractory to medical management, surgical interventions can be helpful. In this review we seek to outline the major tenets of the surgical management of TBI.