PRIMARY OBJECTIVE: Life expectancy may be substantially reduced for many years after severe traumatic brain injury (TBI). This study investigated the patterns of the short- and long-term all-cause mortality and the rates of primary causes of death in patients with severe TBI. SUBJECTS: This study was of 166 consecutive patients (6-82 years) with severe TBI admitted to Sahlgrenska University Hospital, Gothenburg, Sweden, from 1999-2002. The control group consisted of 809 subjects from the community, matched to the TBI cohort for age, gender and postcode area at the time of the injury. METHODS: Survival outcome and cause of death were ascertained 10 years after the injury from the Swedish National Board of Health and Welfare register. The cumulative death rates and causes of death in cases and controls were compared. RESULTS: The risk of death was increased for at least 10 years after severe TBI. The distribution of the causes of deaths differed between cases and controls in the first year of follow-up, but not between 1-year survivors and controls. CONCLUSION: Further research will be required to determine how to improve treatment so as to lower late mortality among survivors of severe TBI.