Traumatic brain injury is the leading cause of death and severe disability in young people, and its most important complication is intracranial hematoma. Without effective surgical treatment, intracranial hematoma is likely to turn a recoverable benign clinical course into death and persistent vegetative survival, and delays in the diagnosis and treatment of intracranial hematoma can produce similar results. The guideline aims to provide thoughtful literature-based recommendations for the surgical management of patients with post-traumatic intracranial occupying lesions, mainly selecting literature on acute occupying lesions occurring within 10 days after trauma, but not on late lesions such as chronic subdural hematoma, subdural hydrocele, and post-traumatic hydrocephalus. Also, the guideline focuses on closed craniocerebral injuries, as many guidelines for the treatment of open traumatic brain injuries already exist. The guidelines categorize post-traumatic occupying lesions according to the traditional classification of the literature, i.e., into acute epidural hematoma, acute subdural hematoma, intracerebral parenchymal injury (cerebral contusion and intracerebral hematoma), acute posterior cranial fossa hematoma, and depressed skull fracture. Of course, most patients with severe traumatic brain injury and some patients with moderate traumatic brain injury may have more than one posttraumatic occupying lesion, for example, most patients with acute subdural hematoma are also found to have cerebral contusions on CT scan. Some patients may have multiple occupying lesions in the brain parenchyma, such as bilateral frontal lobe contusions, bilateral temporal lobe contusions, or simultaneous temporal and frontal lobe injuries. For larger lesions (>50 cm3), treatment options are easier and surgical treatment is generally preferred, whereas smaller lesions (