OBJECTIVE： To compared protective effects of propofol and isoflurane on cerebral tissue of patients with acute traumatic brain injury （aTBI）. METHODS： 100 aTBI patients underwent emergency surgery were randomly divided into propofol group and isoflurane group with 50 cases. Both groups received propofol [4-8 mg/（kg·h）]+fentanyl+vecuronium bromide and isoflurane [inhalation concentration were 0.8％-1.2％]+fentanyl+vecuronium bromide， respectively. The levels of serum S100B protein and neuron specific nolase （NSE） were compared between 2 groups before surgery， at 2 hour in the surgery and at the end of the surgery. MMSE scale score of 2 groups were compared 6 months after the surgery. RESULTS： At 2nd hour in the surgery and the end of the surgery， the serum S100B and NSE levels of 2 groups were significantly higher than before surgery （q＝3.536-4.336， P＜0.05）. The serum S100B and NSE levels of propofol group at the end of the surgery were significantly lower than in isoflurane group （t＝3.622， 3.845， P＜0.05）， with statistical significance. There was no significant difference in MMSE score between 2 groups at 6 months after the surgery （t＝0.614， P＞0.05）. CONCLUSIONS： When the trauma lesions be eliminated in the surgery， the surgery treatment can cause brain tissue damage of the patients with aTBI at the same time. Compared with the application of isoflurane as the maintained anesthesia drugs， the application of propofol as the maintain anesthesia drugs in the surgery can reduce the degree of such brain tissue damage， play a role in protecting brain more significantly， but put no synergistic effect on the recovery of the postoperative neural function of the patients.