Abstract: Objective To investigate the relationship between hemoglobin level and neutrophil/lymphocyte ratio (NLR), and early condition judgment and prognosis of traumatic brain injury (TBI). Methods A total of 353 TBI patients who were admitted in the Affiliated Lianyungang Hospital of Xuzhou Medical University from May 2018 to May 2021 were enrolled. Their clinical data were collected, while the hemoglobin level and NLR of each patient was calculated, so as to analyze the relationship between hemoglobin level and NLR, and the development of PHI and neurological function prognosis in TBI patients. Results Low GCS score, low partial pressure of oxygen (PaO₂), high abbreviated injury scale (AIS) score and high NLR value were the independent risk factors for PHI after TBI (P< 0.05). NLR had the optimal diagnostic efficacy at the cut-off value of 4.6, with a sensitivity of 86.5% and a specificity of 62.1%. The level of hemoglobin had a certain relationship with PHI after TBI, but no stable predictive effect was found. Furthermore, early hemoglobin level and NLR value were significantly related with the neurological function prognosis after TBI (P<0.05). Conclusions For TBI patients, high NLR value indicates an increased PHI risk. High early NLR value and low hemoglobin level in severe TBI patients indicates poor prognosis of neurological function.