【Abstract】Background Traumatic brain injury (TBI) is a leading cause of disability and death in trauma patients. Objective Prompt and appropriate therapy is necessary to obtain a favorable outcome. Content Perioperative management of head-injured patients focuses on aggressive stabilization of the patient and avoidance of systemic (e.g., hypoxemia, hypotension, anemia, hypocarbia, hypercarbia, pyrexia, hypoglycemia) and intracranial insults (e.g., hematoma, raised ICP, seizures, infection, vasospasm) that cause secondary neuronal injury. Secondary brain injury complicates the course of the majority of head-injured patients, adversely influencing outcome. These secondary insults are potentially preventable and treatable.In patients with traumatic brain injury (TBI), perioperative fluid and metabolic management topics include preserving cerebral perfusion pressure (CPP), avoiding hyperglycemia or hypoglycemia, and controlling body temperature. The strategy to preserve the CPP is the varieties and the amounts of the fluid. The glucose level is associated with the prognosis of patients with TBI. Whether hypothermia was beneficial to patients with TBI was still under debate. Trend Fluid and metabolic management is becoming the major subject to the traumatic brain injury patients.