Background: Head injury is a major cause of disability and death in the society, however no effective biochemical prognostic markers are available. Aims: To assess the prognostic significance of admission serum albumin levels in patients of head injury. Material and methods: Prospective cohort study with control group. Within 24 hours of head injury, 115 patients underwent serum analysis for albumin. Statistical analysis was made on the basis of data collected. Results: Mean serum albumin in head injury and control were 3.24 and 4.15 g/dL respectively (p < 0.001). Admission albumin had significant positive correlation with Glasgow coma score (GCS) (p < 0.001). Hypoalbuminemia (≤ 3.5 g/ dL) at admission was noted in 88%, 52% and 33% of patients with severe, moderate and mild head injury respectively (p<0 .001). Conclusions: Admission hypoalbuminemia is an effective indicator of the severity of head injury