【Abstract】 Traumatic brain injury (TBI) is a worldwide public health and social economic problem. After severe traumatic brain injury，Intracranial pressure (ICP) often increases，leading to decreased Cerebral perfusion pressure (CPP)，Cerebral blood flow and oxygenation. These effects further aggravate cerebral edema，creating a vicious cycle that can lead to severe herniation and death. Decompressive craniectomy (DC) is a procedure to remove part of the skull and open up the underlying dura mater to provide extra space for swelling brain tissue，thereby reducing the risk of elevated ICP and cerebral hernia in TBI patients. Although DC improves survival，a higher proportion of DC survivors experience moderate to severe disability. Related disabilities of DC have aroused intense ethical debate. DC and subsequent cranioplasty have been associated with many complications. In this paper，the application progress of DC in severe traumatic brain injury was reviewed，in order to provide help for diagnosis and treatment of severe traumatic brain injury and selection of DC.