Objective To explore the imaging characteristics of computed tomography (CT) in patients with craniocerebral injury and to analyze the relationship between the imaging characteristics and prognosis. Methods The clinical data of 72 patients with craniocerebral injury in our hospital were analyzed retrospectively. The imaging characteristics and Rotterdam CT score were recorded. The prognosis of patients was compared according to the Glasgow Outcome Score (GOS). CT imaging characteristics and Rotterdam CT score were compared among patients with different prognosis. And the correlation between CT signs characteristics, Rotterdam CT score and prognosis was analyzed by Spearman rank correlation analysis. Results Among 72 patients, 13 cases had open basal cistern, 36 cases had partial occlusion and 23 cases had complete occlusion. There were 51 cases of midline shift less than 5mm and 21 cases of midline shift more than 5mm. There were 32 cases of ventricular pressure less than 0.2 and 40 cases of ventricular pressure more than 0.2. There were 30 cases of 3 points of Rotterdam CT score, 21 cases of 4 points and 21 cases of 5 points. There were 48 cases of good prognosis and 24 cases of poor prognosis. The basal cistern score, midline shift and Rotterdam CT score in good prognosis group were lower than those in poor prognosis group (P<0.05), and the ratio of ventricular pressure was also higher than that in poor prognosis group (P<0.05). However, there was no significant correlation between ventricular pressure and prognosis (P>0.05) while basal cistern, midline shift and Rotterdam CT score were significantly negatively correlated with good prognosis (r=-0.511, -0.456, -0.506, P<0.05). Conclusion CT can predict the prognosis of patients with craniocerebral injury by CT imaging characteristics and Rotterdam CT score, and it has certain guiding value to clinic.