Patients with severe traumatic brain injury (TBI) have a higher mortality rate, often dying within a few hours after injury. The management of trauma site, transportation, and early hospital stay is closely related to the outcome of TBI patients. The final success rate of TBI patients varies after different prehospital treatments, and the quality of prehospital treatment for TBI needs to be further improved. Therefore, the TBI prehospital management guideline emerged, and the third version of the guideline was released in April 2023. In order to provide better advice and guidance on the treatment of prehospital TBI, this article interprets the key points of updating the third edition of the prehospital TBI management guideline.