Abstract: Objective To investigate the effect of standard decompressive craniotomy in treatment of patients with severe craniocerebral injury. Methods Totally 150 patients with severe craniocerebral injury were randomly divided into observation group(n=75)and control group(n=75). The control group was treated with routine craniotomy, and the observation group was treated with standard decompressive craniotomy. Glasgow Outcome Scale(GOS)was used to evaluate the clinical efficacy of the two groups. Intracranial pressure level, classification of activities of daily living(ADL), Glasgow Coma Scale(GCS)and complications were compared between the two groups before and after operation. Results The postoperative intracranial pressure level and ADL grading in both groups were significantly lower than those before operation, GCS score was significantly higher than that before operation, and intracranial pressure level and ADL grading of the observation group were significantly lower than those of the control group, while GCS score was significantly higher than that of control group(P<0.05). The total effective rate of the observation group was 93.33%, which was significantly higher than 82.67% of the control group(P<0.05). The total incidence of complications in the observation group was 6.67%, which was significantly lower than 18.67% in the control group(P<0.05). Conclusion Standard decompressive craniotomy is effective in the treatment of patients with severe craniocerebral injury, which can effectively reduce intracranial pressure level and score of ADL grading, increase GCS score, improve postoperative self-care ability, and reduce the incidence of complications.