Abstract： Objective To investigate the characteristics of the head injuries in Wanchuan earthquake and review the experience with on-filed emergency diagnosis and treatment of such injuries. Methods The clinical data were reviewed for 120 patients sustaining head injuries during Wenchuan earthquake in Beichuan and Anxian Counties, Sichuan Province. All the patients received on-filed emergency medical care within one day after the earthquake. The epidemiology, causes and types of trauma, complications and treatment of the injuries were analyzed. Results Of the 120 patients with head injuries, 70 had scalp injuries which were managed with emergency debridement and suture with favorable outcome. The other 50 patients were transferred to general hospitals for intensive medical care, among which 40 received craniotomy and 10 had conservative treatment;46 of these hospitalized patients showed good recovery 5-16 days after admission and were discharged, and death occurred in 4 cases. Conclusion Early and accurate evaluation of the condition of the trauma and effective on-filed emergency management is critical to improving the outcome of head injuries and minimizing the mortality rate related to the injuries in earthquake.