The characteristics of occurrence of head trauma were studied in north central Virginia. In 1978, 735 cases of head trauma were identified with documented head injuries occurring within the defined service area, and with a minimum overnight hospital stay. Overall occurrence was 208/100,000 population. The highest occurrence was found in the 15–19 age group (407/100,000). Nonwhites showed higher rates than whites. Motor vehicle crashes were the most frequent mechanism of injury (55% of patients) followed by falls (20%), and interpersonal violence (11%). Short-term time trends reveal unique daily, weekly, and seasonal patterns for motor vehicle crashes, falls, and interpersonal violence. Selected prevention strategies are discussed. The use of passive restraints in motor vehicles is recommended as one important means of reducing the occurrence and severity of head injuries.