Objective: To explore the treating method for severe craniocerebral trauma combined with transtentorial hernia in children.Methods: We treated 58 children with severe craniocerebral trauma combined with transtentorial hernia through evacuating the hematomas, incising the tentorium but preserving the floating bone flap between January 1996 and January 2002.Results: GCS was 3-5 in 17 cases and 6-8 in 41 cases. After treatment, 46 patients ((79.30)%) recovered well, 6 ((10.30)%) suffered from mild disability, 1 ((1.72)%) suffered from severe disability, 1 ((1.72)%) was in vegetative state, and 4 ((6.90)%) died.Conclusions: Evacuating hematomas and incising tentorium can effectively treat the child patients with severe craniocerebral trauma combined with transtentorial hernia, which can decrease the disability and mortality rates greatly, preserve the skull, exempt reoperation for cranioplasty and relieve the psychologic and physiologic burden of the child patients. Objective: To explore the treating method for severe craniocerebral trauma combined with transtentorial hernia in children. Methods: We treated 58 children with severe craniocerebral trauma combined with transtentorial hernia through evacuating the hematomas, incising the tentorium but preserving the floating bone flap between January 1996 and Results: GCS was 3-5 in 17 cases and 6-8 in 41 cases. After treatment, 46 patients ((79.30)%) recovered well, 6 (10.30)%) suffered from mild disability, 1 (( 1.72)%) suffered from severe disability, 1 ((1.72)%) was in vegetative state, and 4 ((6.90)%) died. Conclusions: Evacuating hematomas and incising tentorium can effectively treat the child patients with severe craniocerebral trauma combined with transtentorial hernia, which can decrease the disability and mortality rates greatly, preserve the skull, exempt reoperation for cranioplasty and relieve the psychologic and physiologic burden of the child patients.