OBJECTIVE: This study aimed to describe the incidence and status of acute management of traumatic brain injuries (TBIs) in Korea. METHODS: We utilized nationwide administrative data from the National Emergency Department Information System (2016-2018), focusing on patients with TBIs who visited emergency medical centers within 7 days of injury and were treated in neurosurgery. RESULTS: The study included 117,830 patients, indicating an annual crude incidence of 79.4 TBIs per 100,000 persons. The highest incidence was in the age groups 0-4 and 75-79 years, with men experiencing TBIs more often than women (79.3 vs. 60.4). Traffic accidents were the most common cause (34.2%). Ambulance transport accounted for 65.4% of cases, with a median hospital arrival time of 62 minutes. Only 7.6% of patients were admitted to trauma care units, showing significant regional variations. Craniotomy or craniectomy was performed in 4.8% of cases. Normal discharge occurred in 69.3% of patients, and the overall in-hospital mortality rate was 5.3%, higher in men (3.9% vs. 1.5%). CONCLUSION: In Korea, the incidence of TBIs vary by age, sex, and regions. Current status of management of TBIs also differs by regions, especially between metropolitan city and province. Tailored strategies for TBI management are needed based on these differences.