Background: Head injury is one of the most important public health problems today. The outcome of patients with depressed fracture varies and depends on multiple factors. This study aimed to assess the surgical outcomes of depressed skull fracture (DSF) Patients and methods: this study included 50 cases withdepressed fracture of the skullwho admitted to Neurosurgery department, Zagazig University Hospitals. Glasgow coma scale score(GCS) was evaluated for all patient at hospital admission and post-operatively.All patients in the study were managed operatively. Results: The mean age of the studied patients was 27.8± 6.9, 70% of cases were males and 30 % were females. The commonest cause of depressed skull fracture was road traffic accident, seen in 33 patients (66%); whereas in 24 % mode of injury was fall from height and 10 % was fall from height. All patients presented with the main complaint of altered level of conscious (96%) followed by vomiting (52%), fits (34%) and 18 % of patients had bleeding. The commonest site of fracture was frontal region seen in 38 cases (76%). Compound fracture of skull was found in 72 % of cases whereas simple fracture was found in 28% of cases. We found significantcorrelation between GCS at presentation and final outcome of patient. Conclusion: Our observation suggests that patients brought to hospital with DSF without delay and preoperative GCS score not less than 13, have improved outcome.