The features of head injury at Prince of Wales Hospital, Hong Kong, were determined by reviewing the medical records of head-injured patients admitted to its neurosurgical service during the period commencing January 1989 to December 1993. During this time, there was a decline in the total number of head injury admissions. This reduction was secondary to a decrease in admissions for minor head injuries. The number of severe head injuries remained constant during these years. Falls represented the leading cause of head injury and accounted for more than 50% of all head injury admissions. Fall from a height was mainly a paediatric problem and falling at ground level was most common in the elderly. In teenagers and young adults, the most common causes of head injury were bicycle- and traffic-related accidents. Traffic-related accidents accounted for more than 50% of all head injury fatalities. There was a direct relationship between age and the mortality rate.