Aim – The study done to evaluate the role of decompressive craniectomy in patients with traumatic intracranial hematomas. Introduction – Although decompressive craniectomy for traumatic brain injury is very effective procedure in patients with raised intracranial pressure refractory to medical measures, its effect on clinical outcome is still unclear because of both positive as well as negative impact of procedure. As after decompressive craniectomy, clinical outcome becomes mainly dependent on primary head injury as secondary injury is prevented by decompressive craniectomy and beneficial effect of decompressive craniectomy is partially neutralized by complications associated with it to a small but significant extent. Patients and method – we retrospectively analysed 72 patients operated in last five years for traumatic intracranial hematomas by decompressive craniotomy. We followed practice of large craniotomy and evacuation of hematomas in last five years in properly selected patients and reserving craniectomy as second procedure in patients in whom patient did not improve radiologically/clinically after craniotomy. Results – In 61 out of 72 patients operated by decompressive craniotomy, there has been significant improvement in GCS of patients and none of patients needed decompressive craniectomy.