Dilated pupils on both sides of the brain hernia are generally more serious, indicating that the patient’s condition is critical and needs to be resuscitated by taking general measures, medications, and surgical treatments in a timely manner. Brain hernia belongs to a serious symptom of neurological diseases, in most cases, the pupil dilatation on both sides of the brain hernia is serious, considering that the patient’s condition has entered a critical state. If it is cerebellar hiatal hernia, when the condition deteriorates, the patient will have bilateral pupil dilation, the symptoms of light reflex disappearance, meaning that the patient is in a state of near death. In the case of occipital foramen magnum hernia, the patient is prone to pupil dilatation and respiratory arrest in the early stage. At this time, it is necessary to carry out emergency rescue, take tracheal intubation to maintain respiratory and circulatory function, and follow the doctor’s instructions to use mannitol solution to quickly reduce intracranial pressure, or take ventricular puncture drainage, internal decompression surgery, decompression of the debridement flap and so on. When the brain hernia patients appear both sides of the pupil dilatation, need to take timely and appropriate treatment measures, so as not to delay the condition.