Background:Traumatic Brain Injury (TBI) is a major public health concern, and circulatory shock following moderate-to-severe TBI can significantly impact patient outcomes. This study aims to investigate the risk factors associated with circulatory shock in TBI patients and assess its impact on neurological outcomes. Materials and Methods:This prospective study was conducted at the Gouri Devi Institute of Medical Sciences and Hospital from December 2022 to November 2023 GIMSH. A total of 70 TBI patients with moderate-to-severe injuries were included in the analysis. Demographic, clinical, and radiological data were collected, and the occurrence of circulatory shock was monitored. Neurological outcomes were assessed using standardized scales. Statistical analysis was performed using appropriate tests, and the significance level was set at p < 0.05. Results:Out of the 70 TBI patients included in the study, 20 (28.6%) developed circulatory shock during their hospitalization. The risk factors significantly associated with the development of circulatory shock included age > 65 years (OR: 2.34, 95% CI: 1.12-4.89, p = 0.023), presence of pre-existing cardiovascular disease (OR: 3.76, 95% CI: 1.68-8.42, p = 0.006), and admission Glasgow Coma Scale (GCS) score ≤ 8 (OR: 4.21, 95% CI: 2.15-8.26, p < 0.001). Patients who experienced circulatory shock had a significantly worse neurological outcome at discharge, as indicated by a lower median Glasgow Outcome Scale (GOS) score (2.5 vs. 4.0, p < 0.001). Conclusion:Circulatory shock is not uncommon in patients with moderate-to-severe TBI, and it is associated with several risk factors, including older age, pre-existing cardiovascular disease, and lower GCS scores at admission. Additionally, the presence of circulatory shock is associated with poorer neurological outcomes upon discharge. Early identification and management of these risk factors may improve outcomes for TBI patients.