This chapter is divided into two parts. First part describes injury to brain and second part depicts pathology of spinal cord in head injury. The chapter has well written text and 37 well illustrated diagrams showing pathology of head injury, traumatic brain injury, raised intracranial pressure, ischemic brain damage, diffuse axonal injury, brain stem injury, head injury in children, road traffic accident and upper cervical cord injury. Brain injury and molecular response, role of Apolipoprotein E and ethanol in brain damage are described in detail. Pathology and pathogenesis of spinal cord injury are described in detail. 7 tables are included to highlight causes and mechanism of brain and spinal cord injuries. 199 references are given for further reading in first part and 61 references are given for further reading in second part of the chapter for spinal cord injury.