We aim to discuss factors especially age affecting the effectiveness of decompressive craniectomy in traumatic brain injury in the light of current literatüre. 44 patients who experienced decompressive craniectomy were analyzed, according to the Glasgow coma scale (GCS), midline shift, age, and outcome scores retrospectively. There were 44 patients, 26 males and 18 females, with a mean age of 54,72 years (range 20-78 years). Glasgow coma scale (GCS) scores ranged from 5 to 11 preoperatively. The midline shift was 10 mm (range 4-27 mm) on brain computed tomography (CT). Increased age (>55 years), preoperative midline shift >9 mm, low preoperative GCS (<8), preoperative findings of herniation, early clinical deterioration (within the first three days of traumatic brain injury), and delayed surgical intervention were predictors of a poor outcome. Decompressive craniectomy can be life-saving in young patients if it is done in patients and timely, but the effectiveness of surgery on morbidity and mortality is related to several other factors.