BACKGROUND: Head injury as a result of trauma is an important cause of long-term disability. Recently published guidance from the National Institute for Clinical Excellence on Acute Head Injuries and a forthcoming National Service Framework for Long-Term Neurological Conditions provides renewed focus on this practice specialty. AIMS AND OBJECTIVES: This article presents a narrative review of a range of quantitative and qualitative studies that have explored the impact of head injury and postinjury disabilities on patients' and families lives. RESULTS: Patients may experience a range of physical, emotional, cognitive, social and behavioural problems after head injury that will have a significant impact on both their own and their families' everyday lives. It is important that the behavioural, physical and psychological aspects of head injury are addressed. Carers may be vulnerable to stress and anxiety as a result of their caring role. CONCLUSIONS: It is often in the longer term that the true complexity and impact of head injury may become apparent. Ongoing support, from a range of services, will be required to assist both patient and family to cope with their circumstances. Ensuring that practice is evidence based, it is necessary to conduct further research, both to explore the effectiveness of current service provision and investigate those aspects deemed important by patients and carers. RELEVANCE TO CLINICAL PRACTICE: As nurses play an important role in both the acute and long-term care and support of those who have suffered a head injury, it is vital that they are aware of the wide ranging needs with which patients and families may present.