Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 8 4 2025 12 31 128 136 Maryam Ziaie Department of Emergency Medicine, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran Mehdi Galavi Department of Emergency Medicine, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran Armaghan Hosseinsarbazi Department of Emergency Medicine, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran Alireza Bahmani Department of Emergency Medicine, Khatam Al-Anbia Hospital, Zahedan University of Medical Sciences, Zahedan 2025 10 27 Background: Traumatic brain injury (TBI) is one of the leading causes of emergency department admissions and neurological morbidity among children worldwide. Identifying epidemiological trends, mechanisms of injury, and outcome predictors is essential for guiding preventive strategies and improving clinical  anagement. This study aimed to evaluate the epidemiological characteristics, mechanisms, and outcomes of pediatric head trauma cases presenting to the emergency department of Khatam-Al-Anbia Hospital in Zahedan, Southeast Iran, during 2022–2023. Methods: This descriptive, retrospective, cross-sectional study included 112 children under 16 years of age with documented head trauma. Data were extracted from hospital records using a standardized checklist covering demographic variables, mechanism of injury, trauma severity (based on the Glasgow Coma Scale; GCS), and neurological outcome (discharge or death). Consecutive non-probability sampling was applied. Statistical analysis was performed using SPSS version 26.0, employing descriptive statistics and the Chi-square test to explore associations between clinical variables and outcomes. Results: Of the 112 cases, males comprised 76.8%, and the 6–12-year age group accounted for the largest proportion (48.2%). Road traffic accidents were the predominant cause of trauma (54.5%), followed by falls. Regarding injury severity, 50.0% had mild, 26.8% moderate, and 23.2% severe injuries. The overall mortality rate was 4.5%. Although no significant association was found between age or gender and neurological outcomes, injury severity demonstrated a borderline significant relationship with mortality (p = 0.076). Conclusions: Pediatric head trauma remains a major cause of morbidity and mortality in Southeast Iran, predominantly affecting school-aged boys and primarily resulting from road traffic accidents. Injury severity is a key determinant of outcome. These findings highlight the urgent need for enhanced parental education, implementation of school-based safety programs, and strengthening of prehospital and in-hospital trauma care systems to reduce preventable deaths and improve outcomes. https://ajs.tums.ac.ir/index.php/ajs/article/view/328