Objective: To analyze the influencing factors of NIHSS score in patients with severe brain injury after operation. Methods: 100 cases of severe craniocerebral injury patients treated in our hospital from March 2013 to June 2015 were selected as abject, single factor variance analysis, t-test and multiple stepwise regression analysis were used to explore the factors that influent after severe craniocerebral injury patients with NIHSS score. Results: Among the 100 cases, 38 cases were mild neurological functional defect, 46 cases were middle nerve function injury, 16 cases were severe neurological deficit; NIHSS score of patients with older age, presence of abnormal breathing, low blood pressure, combined injury, pupil scattered, pupillary light reflex disappeared, intracranial hematoma volume large, digestive tract hemorrhage, hydrocephalus patients was higher, the difference was statistically significant; single factor analysis of meaningful factors: age, abnormal breathing, hypotension, combined injury, pupil scattered, pupil of reflected light, intracranial hematoma, digestive tract hemorrhage, hydrocephalus as independent variables, to postoperative patients with NIHSS score as the dependent variable and multiple stepwise regression analysis, age, intracranial hematoma, cerebral water enter the regression equation. Conclusion: The NIHSS score of patients with severe craniocerebral injury is closely related to the age, the amount of intracranial hematoma and hydrocephalus.