Abstract: In severe head injury brain midline shift in Computerized Tomography (CT) scan is a diagnostic sign. The aim of this study was to investigate prognostic value of brain shift by studying of correlation between brain shift and interpeduncular cisternal effacement with long term outcome, in patients with Glasgow Coma Scale (GCS) 8 with epidural haematoma. One hundred patients with sever head injury and epidural haematoma (GCS 8) were enrolled in this study. All of the patients underwent clinical examination and brain CT scan. Brain shift and interpeduncular cisternal effacement measured from CT scan. Outcome in surviving patients was determined at 3 and 9 months after admission. Of the 100 patients admitted to the study, 18 had GCS = 8. 22 had GCS = 7. 25 had GCS = 6 and 17, GCS = 5 and 18 had GCS = 4. As mental status declined, uncal herniation in CT scan was significant. There was meaningful relationship between GOS and midline shift (p = 0.045 for GCS = 8, p = 0.033 for GCS = 7, p = 0.048 for GCS = 6, p = 0.021 for GCS = 5 and p = 0.038 for GCS = 4). Analysis of outcome for all cases showed a statistically meaningful correlation between outcome and interpeduncalar cisterns effacement (p = 0.044 for GCS = 8, p = 0.038 for GCS = 7, p = 0.031 for GCS = 6, p = 0.047 for GCS = 5 and p = 0.050 for GCS = 84). There was a meaningful relationship between admission GCS and lateral brain shift and interpeduncular cisternal effacement with 3 and 9 months GOS in patients with sever head injury (GSC 8) with epidural haematoma.