Traumatic brain injury continues to be a major socioeconomic problem, costing the United States $76.5 billion in the year of 2000. Despite the advances in the field of medicine, there are still no definitive treatments for traumatic brain injury. Goal of therapy is still gearing toward supportive cares such as intracranial pressure monitoring, lowering intracranial pressure, correcting cerebral ischemia, and manipulating serum osmolarity. The search for effective treatment in human studies has been unfruitful. In this review, the mechanisms of primary and secondary brain injury are discussed along with potential neuroprotective interventions such as hyperosmolar therapies, hypothermia, statins, and cyclosporin A.