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Worldwide, traumatic brain injury (TBI) is one of the main causes of mortality and morbidity. Severe TBI patients often require emergency neurosurgery and/or invasive neuromonitoring to improve mortality and neurological outcomes. Early management of patients with severe TBI and polytrauma within the golden hour represents a major challenge. Robust guidelines for the treatment of these difficult patients in setting with inadequate resources are lacking. This is a retrospectively performed descriptive study of a series of patients operated on for neurotrauma by a general surgeon at a peripheral military hospital under telemedicine guidance by a neurosurgeon. The neurosurgeon’s opinion was taken in all the cases about the need, urgency, and the kind of procedure to be performed. Extended Glasgow Outcome Scale (GOSE) was used as a determinant of outcome. Seventeen patients were classified into the category of severe TBI. Sixteen patients had a favourable outcome (GOSE scores 5–8), while seven patients had an unfavourable outcome (GOSE scores 1–4). A total of six cases (26.08%) had fatal outcomes, all of which presented with severe TBI with a mean GCS of 3.5 ± 1.25. It is the need of the hour that emergency neurotrauma care at remote locations is provided by general surgeons with adequate guidance from neurosurgeons. To effectively treat neurotrauma, general surgeons must undergo periodic training under a neurosurgeon. To this end, zonal and tertiary care hospitals must collaborate. [ABSTRACT FROM AUTHOR]