Evidence accumulated over the past decade have led to recognition that, for many patients, traumatic brain injury (TBI) continues to evolve after the acute period and initial recovery. Multiple rigorous epidemiologic studies indicate that there is a modest increase in risk late life dementia and cognitive impairment in individuals who sustain a TBI in early and mid-life. Despite the substantial societal burden imposed by the long-term neurodegeneration after TBI, very little is known about the pathophysiology involved, there are no biomarkers that are prognostic for identifying individuals at risk for progressive neurodegeneration, and no effective therapies to prevent or slow this process. This session will review the newest epidemiological data, discuss new insights from neuroimaging and biomarker studies, and examine practical strategies that can be applied clinically.