Although head trauma is a potentially life-threatening emergency, affected animals can be successfully managed in private practice. A basic understanding of the pathophysiology of traumatic brain injury and intracranial pressure mechanisms will help you make rational clinical decisions. When confronted with patients with head trauma, it is important to stabilise the patient, assess the prognosis, and follow a stepwise approach. We will discuss how to recognise patients with a grave prognosis, how to manage and monitor patients with head trauma in practice, and the importance of having realistic expectations. You will see that treating patients with head trauma in private practice might be easier than you think.