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RATIONALE Severe brain injury often induces a state of malnutrition due to insufficient caloric and protein input. If left untreated, it will have a negative impact on rehabilitation. Nutritional therapy provides caloric and the nutritional support necessary to cover the daily needs and help contrast hospital infections. Our hypothesis is that integration of natural foods in the daily diet can enhance the recovery of the state of malnutrition and increase rehabilitation outcomes. PATIENT CONCERNS We present the case of a young man with traumatic brain injury caused by a car accident. Who underwent tracheostomy and percutaneous endoscopic gastrostomy (PEG) procedures, had severe consciousness disorder, was severely malnourished and therefore underweight. DIAGNOSIS He was severely underweight, malnourished, with a severe consciousness disorder that necessitated the tracheostomy and the PEG. INTERVENTIONS Our approach included caloric implementation of artificial nutrition and the gradual introduction of semi-liquid natural foods administered through PEG. OUTCOMES The patient was followed for a year during which the metabolic/nutritional pattern and the blood tests improved, normal weight restored, and consciousness regained. CONCLUSION Nutritional intervention integrated with natural foods, has allowed a gradual increase in weight, a better recovery of the lean mass and the stabilization of the metabolic-nutritional framework.Nutritional approach used has contributed to the reduction of recovery times, making the therapeutic path more effective.