The Visual Response Evaluation (VRE) was developed to meet the need for a formal and in-depth measure of visual responses in low-level brain-injured persons (Rancho Levels II and III) and to monitor and document minute changes in the recovery of these patients. Often, patients at these low functional levels exhibit little to no motoric or cognitive interaction with the environment, except that which occurs in response to sensory stimulation. Other tools have been developed to document responses to various types of stimulation; however, none contain the sensitivity to consistency and type of response that is necessary to show the small but vital progress that is characteristic of the Rancho II and III type patient. The VRE consists of 10 items separated into two general categories: (1) Observations, and (2) Response to Stimuli. The five items in the Observations section assess a patient's spontaneous responses, while the five items in the Response to Stimuli section document responses directly related to the presentation of a hierarchical order of stimuli. The VRE was administered to 10 patients with a mean age of 39.8 years at a mean time of 4.2 months post-injury. Statistical analyses of the pilot-study data show the VRE to be both internally reliable and criterion-related valid at theP<0.025 level of significance. The data supports further investigation in the areas of prognostic ability and implications for treatment. The VRE can be a useful tool for studying the recovery process and evaluating treatment programmes for low-level brain-injured persons.