Objective To investigate the clinical effect of long-tunneled external ventricular drain （LTEVD） in the treatment of intracranial infection with extensively drug-resistant Acinetobacter baumannii （XDR-AB） after surgery for severe traumatic brain injury （TBI）.Methods A retrospective analysis was performed for the clinical data of 65 patients with intracranial infection after craniotomy for TBI who were admitted to Xiangya Hospital of Central South University from January 1， 2014 to December 31， 2018， among whom 50 patients received short-tunneled external ventricular drain （STEVD） （STEVD group） and 15 received LTEVD for intracranial infection with XDR-AB （LTEVD group）. All patients received standardized management in the perioperative period， and antibiotics were administered based on the drug susceptibility results of cerebrospinal fluid bacterial culture； the patients with XDR-AB infection were given intraventricular polymyxin B.Results There were no significant differences between the two groups in general features， incidence rate of hydrocephalus， rate of new infections， and mortality rate （P >0.05）. The STEVD group had a duration of intraventricular drainage tube placement of 10.7±5.3 d， with a median of 10.0 d， while the LTEVD group had a duration of 31.7±9.2 d， with a median of 32.0 d； there was a significant difference in the duration between the two groups （P <0.05）.Conclusions LTEVD can extend the duration of external ventricular drainage to more than 1 month with good safety and clinical effect， and therefore， it is suitable for patients requiring a long duration （>4 weeks） of cerebrospinal fluid drainage due to refractory intracranial infection or intracranial/extracranial effusion. ［Journal of International Neurology and Neurosurgery, 2021, 48(1): 4-8］