Objective To evaluate the prognosis and influence of high-volume hemofiltration(HVHF) on intracranial pressure(ICP) in patients with severe traumatic brain injury.Methods A total of 90 patients with severe traumatic brain injury who had Glasgow Coma Scale scores(GCS) of 3-8 were divided into two groups according to different treatment approaches. The control group(n=30) received conventional therapy, and the treatment group(n=60) was treated with HVHF in addition to the conventional therapy. Change in ICP and prognosis were evaluated 2 weeks after the treatment.Results The ICP of patients in treatment group on days 3, 7, and 14 of treatment was significantly lower than that in control group on respective days (all P<0.05). The serum levels of interleukin-6 and tumor necrosis factor-α in treatment group on days 3, 7, and 14 of treatment were significantly lower than those in control group on respective days (all P<0.05). The incidence of postoperative complications and overall mortality in treatment group were significantly lower than those in control group (both P<0.05).Conclusions HVHF treatment markedly slows the rise of ICP and greatly improves the prognosis in patients with severe traumatic brain injury after surgery.