Objective To investigate, analysis of clinical curative effect in the treatment of severe traumatic brain injury after tracheotomy. Methods 60 cases of severe traumatic brain injury were treated in our hospital from May 2013 to July 2014, in which 30 cases were randomly divided into two groups, and named as rehabilitation group and control group. The rehabilitation group received tracheotomy in the treatment, the control group were given endotracheal intubation in the treatment, and the two groups of patients hospitalized time, pneumonia incidence and mortality were compared. Results Two groups of patients after surgery, in which the incidence of pneumonia and mortality were not statistically significant, the control group was 46.7%, mortality rate was 20%, while the recovery group was 43.3% and 16.7% respectively, but the two groups of patients were treated with the average time of the control group (13.2 + 3.5) days, and the patients in the rehabilitation group were (9 + 4.5) days. Conclusion For severe traumatic brain injury patients with tracheotomy can promote as soon as possible in patients with spontaneous breathing and the operation simple, should be popularized and applied in clinical emergency, in order to win rescue time.