Abstract： Objective To retrospectively analyze the clinical efficacy of standard decompressive craniectomy in the treatment of severe traumatic brain injury.Methods One hundred and fifty patients with severe traumatic brain injury who underwent standard decompressive craniectomy at the hospital from January 2018 to January 2023 were selected as the observation group,150 patients with severe traumatic brain injury who underwent conventional craniectomy during the same period were included in the control group.The clinical effects of sur-gical treatment were compared between the two groups,and the changes in intracranial pressure and postoper-ative complications at 1,5,and 7 days after surgery were compared.Results The total effective rate of sur-gery in the observation group was 92.11％,while the total effective rate of surgery in the control group was 73.68％,with a statistically significant difference(P＜0.05);On the 1st,5th,and 7th day after surgery,the intracranial pressure in the observation group was(18.49±2.31)mmHg,(17.21±2.51)mmHg,and(15.47 ±1.91)mmHg,respectively.The control group was(20.73±2.39)mmHg,(20.52±2.39)mmHg,and(20.55±1.79)mmHg,respectively,The observation group was lower than the control group,and the differ-ences were statistically significant(P＜0.001);There were 6 cases(8％)of postoperative complications in the observation group and 12 cases(8％)in the control group,with a statistically significant difference(P＜0.05).Conclusion The standard decompressive craniectomy is used for the treatment of severe traumatic brain injury,and its clinical effect is superior to conventional craniectomy.