Objective: To improve the diagnosis and treatment of severe cerebral fat embolism (SCFE).Methods: The data of nine patients with SCFE were retrospectively analyzed. The manifestations of the central nerve system, respiratory system and hemorrhage were recorded, at the same time, accessory examination including arterial oxygen, fat macroglobules in venous blood and image examination was adapted. The patients were treated with exopexy, pharmocotherapy and oxygentherapy.Results: Two of the nine patients died of severe complications, the other seven recovered without severe sequela.Conclusions: Gurd standard should be improved for early diagnosis of SCFE. If svere complications can be prevented, patients who receive early treatment will have favourable prognosis.