Abstract: ob＜x＞jective To discuss the application value of cisternostomy in the treatment of severe traumatic brain injury (sTBI). Materials and methods: 40 patients with sTBI were collected in the Deaprtment of Neurosurgery, Xuzhou First People’s Hospital. They were randomly divided into subdural drainage group (n = 20) and cisternostomy drainage group (n = 20). The intracranial pressure at 0 h (at the end of operation), 6 h, 12 h, 1 day, 3 days and 7 days after operation and the Glasgow coma score (GCS) after operation (1-14 days) were statistically analyzed between two groups. Results: The intracranial pressure in cisternostomy group was lower than in subdural drainage group at different time points after operation, and there was significant difference respectively (P < 0.05). There was no significant difference in the intracranial pressure on 0h (at the end of operation) between two groups. The average GCS scores of 5 days, 7 days, and 14 days in the cisternostomy group were higher than that in the subdural drainage group, and the difference was statistically significant (P < 0.05). Conclusion: The cerebrospinal fluid drainage after cisternostomy can effectively reduce the intracranial pressure, relieve obstruction of cerebrospinal fluid circulation, and improve the prognosis in patients.