Abstract: Objective: To explore the value of early brain CT image score, serum matrix metalloproteinase (MMP-9) and neuron-specific enolase (NSE) in evaluating the prognosis of children with craniocerebral injury. Methods: 135 children with craniocerebral injury were selected. All the children were scanned by CT after admission. The scores of CT images were recorded. Serum levels of MMP-9 and NSE were detected 24 hours after injury. According to Glasgow Coma Score (GCS), the children were divided into light group (56 cases), medium group (48 cases) and heavy group (31 cases). The clinical outcomes of the children were tracked. The children were divided into survival group (103 cases) and death group (32 cases) according to whether they died within 30 days. The differences of CT image score, serum MMP-9 and NSE levels between different groups were observed, and CT image score, serum MMP-9 and NSE were analyzed. The correlation between level and GCS score, ROC analysis of CT image score, serum MMP-9, NSE level to predict the prognosis of children with craniocerebral injury. Results: CT score, MMP-9 and NSE increased with the severity of brain injury in children (P<0.05). The scores of CT, MMP-9 and NSE in the surviving group were lower than those in the death group (P<0.05). CT scores, MMP-9 and NSE were positively correlated with GCS scores (r=0.684, 0.462, 0.310, P<0.05), and CT scores were positively correlated with MMP-9 and NSE (r=0.493, 0.282, P<0.05). The AUC of CT score, MMP-9 and NSE predicting the prognosis of children with craniocerebral injury were 0.996, 0.943 and 0.758, respectively. Conclusion: Early brain CT image score, serum MMP-9 and NSE are related to the severity and prognosis of craniocerebral injury in children, and can be used as reliable indicators to predict the prognosis of craniocerebral injury in children.