OBJECTIVE: To determine the mean length of hospital stay in pediatric patients with severe blunt traumatic head injury receiving 3% hypertonic saline in the emergency department. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: This study was conducted at the Department of Emergency Medicine, Aga Khan University Hospital, Karachi, from 2014 to 2015. METHODOLOGY: This study consisted of one hundred and five patients. Detailed clinical examination of the patients was done with co-morbidity. Pediatric patients between 2 to 16 years of either gender with moderate to severe head injury were included in our study. The patients were categorized as moderate and severe on the basis of the GCS as per the Brain Trauma Foundation. 3%Hypertonic saline resuscitation was done as per routine care. After 6 hours GCS was recorded. The patients were admitted in hospital and followed and the discharge GCS was recorded. RESULTS: Out of 105 patients included in this study 76 (72.4%) males and 29 (27.6%) females. The mean age in months was 61.6±45.9 months. Traumatic brain injury was moderate in 65 (61.9%) and severe in 40 (38.1%) of our patients as per the GCS. 6 hours after resuscitation with 3% hypertonic saline patients with normal GCS were 45 (42.9%). Patients with Moderate brain injury were 39 (37.1%) GCS at discharge was Normal in 94 (90.4%). Majority of our patients had in hospital stay of 2-3 days 45 (42.9%). The GCS improved after resuscitation with a mean length of stay of 4.6±3.9 and 12.6±10.7 in moderate and severe head injury with a p value of <0.001. CONCLUSION: We conclude that patients with traumatic head injury receiving 3% hypertonic saline results in the decrease in hospital length of stay and improvement in GCS. Keywords: Hypertonic saline, Traumatic Brain Injury, Head Injury, Glasgow Coma Scale, Trauma