Background Epidural hematoma is when bleeding occurs between the tough outer membrane covering the brain (dura mater) and the skull. Often there is loss of consciousness following a head injury, a brief regaining of consciousness, and then loss of consciousness again which occurs in 20 to 30 percent. Other symptoms may include headache, confusion, vomiting, and an inability to move parts of the body. Complications may include seizures, or even death (1-3). . Objectives; The aim of study was to assess the short term operative outcome of patients with traumatic brain injury having extra-axial collection admitted at Tibebe Ghion Specialized Hospital. Methods; It is hospital based cross sectional study on patients who were admitted at TGSH with Traumatic brain injury with extra-axial collection was conducted from April 1, 2020 to August 30, 2020 G.C. I include all patients who presented with clinical and imaging diagnosis of acute epidural hematoma and acute subdural hematoma with all severity level of traumatic brain injury in my study. Those who had incomplete documentation or documented as death upon arrival and admitted out of given period will be excluded. Result Among 185 patients the rate of traumatic brain injury with extra-axial collection is more common in male (86.5 percent) with age mean of 34.3.the mean duration of trauma was 25 hours and hospital stay was 91 hours. The commonest mechanism of injury is stick injury (34.1 percent) followed by RTA (29.7 percent).about half patients have GCs of 14 at admission. Associated injury that end up in operative management was seen in 10.3 percent and post traumatic seizure was experience by 9.2 percent of patients. 31 percent of 185 patients had extra-axial collection associated with parenchymal lesion and 2 patients had both AEDH and ASDH. Majority (44.9 percent) had isolated acute epidural hematoma and craniotomy with with epidural hematoma evacuation was the commonest operative procedure done (25.9). At three months significant number of patients ( 81 percent) resumed their routine activity with or without minor deficit. The overall survival rate was found to be 89.2 percent. Conclusion There was pronounced male preponderance than previous studies. Average age is in line with other previous studies. Etiology is predominately stick than RTA. Acute epidural is more common than subdural hematoma. The outcome is in line with previous studies in European set up. Rate of operative management is better than other African studies. Majority are mild and moderate forms. The three month functional outcome status is encouraging