Objective To investigate the factors associated with the accuracy of external ventricular drain placement in patients with traumatic brain injury (TBI).Methods The clinical data and computed tomography (CT) findings of 111 patients with TBI, who had undergone external ventricular drain placement and thin-slice CT scans, were retrospectively reviewed. The factors that affected the accuracy of external ventricular drain placement were identified by logistic regression analysis.Results A total of 79 patients achieved tube patency and smooth cerebrospinal fluid flow, and the success rate of external ventricular drain placement was 71.17%. The main factors that affected the accuracy of external ventricular drain placement were the surgical experience of neurosurgeons. The sex, age, preoperative Glasgow Coma Scale score, type of TBI, midline shift before operation, and puncture point (left or right side) did not seem to affect the accuracy.Conclusions The accuracy of external ventricular drain placement is associated with the surgical experience of neurosurgeons, so we still need to improve the success rate of external ventricular drain placement through navigation techniques.