Abstract: Objective To investigate the effect of serum thyroid hormone levels on mortality and severity of patients with severe traumatic brain injury. Methods Seventy-five patients with severe traumatic brain injury who were hospitalized in Tangshan Gongren Hospital from January 2013 to January 2015 were selected as the patient group, and 50 people without thyroid disease at the same period were recruited as the control group. Glasgow Coma Scale (GCS) was applied to assess the severity of severe traumatic brain injury. Serum thyroid hormone levels were detected by chemiluminescence method. The mortality was calculated. Serum thyroid hormone levels were compared between the two groups. The effect of serum thyroid hormone levels on mortality and severity of the patients with severe traumatic brain injury was analyzed. Results Serum free triiodothyronine (FT3) and total thyroxine (TT3) levels of the patient group were lower than those of the normal control group (P < 0.05). Serum FT3 and TT3 levels were both correlated with the severity of the patients (P < 0.05); moreover, serum FT3 and TT3 levels affected the mortality of the patients with severe traumatic brain injury. Conclusions Serum thyroid hormone levels significantly alter in the acute period of the patients with severe traumatic brain injury. The lower the serum FT3 and TT3 levels, the severer the patients' condition, and the higher the mortality of the patients.