Optimizing acute TBI management determines the potential for recovery and the efficacy of all subsequent interventions. This presentation will discuss the latest advances in physiological assessments, Neurotrauma monitoring and subsequent management strategies following moderate and severe TBI (m/s TBI). Controversies around management paradigms such as the indications for decompressive craniectomies and the timing of cranioplasty to name a few will be discussed. Multidisciplinary knowledge translation from TRACK-TBI and the NASEM report will also be addressed including an action plan aimed at improving long term meaningful outcomes for patients and families. Time for Q and A with an expert panel discussion will be allotted for.