Objective To investigate the causes, diagnosis and treatment, and prognostic factors for traumatic brain injury with optic nerve damage.Methods A retrospective analysis was performed on the clinical data of 124 cases of traumatic brain injury with optic nerve damage in our hospital. The methods for diagnosis and treatment were summarized. The prognostic factors were identified by univariate analysis (Chi-square test).Results In the 124 patients, the overall response rate was 70.31%; 60% of all patients showed a response to surgical treatment, and 71.56% showed a response to drug therapy. Unconsciousness and optic canal fracture were not related to prognosis (P>0.05). Light sensation, treatment time, and VEP waveforms were significantly associated with vision recovery (P<0.05).Conclusions The treatment of traumatic brain injury with optic nerve damage has low effectiveness, but early diagnosis and treatment can lead to good results. At present, drug therapy is still the main treatment. Surgical treatment should be given to patients with surgical indications early to improve their quality of life.