This cross-sectional, descriptive study identified 857 head-injured patients who were admitted to the University Hospital of the West Indies (UHWI) over a four-year period. Their median age (IQR) was 28 (16, 45) years and 629 (73.5%) were males. Median length of hospital stay (IQR) was 2 (1, 6) days. Median ICU stay in the intensive care unit (IQR) was 6 (2, 12) days for the 59 (6.9%) patients admitted there. Most patients (73.3%) were admitted with unintentional injuries resulting from road traffic accidents (48.9%), of which passengers were the most commonly affected, and from falls which occurred in 24.4%. Intentional injuries accounted for 26.7% of those admitted, consisting mainly of assaults with blunt objects in 18.0% (154/857). Penetrating injuries were less common, accounting for 67 (7.8%) injuries. Among these, there were 23 gunshot wounds of the head (2.7%). Head injury in admitted patients is mainly due to road traffic accidents, falls and interpersonal violence. Prevention and interventional strategies including education, law enforcement, physical and social engineering must focus on these aetiologies. Current measures are clearly insufficient and more effective strategies are urgently warranted.