Objective: To investigate the value of invasive continuous intracranial pressure monitoring in treatment of severe traumatic brain injury (sTBI). Methods: 130 cases of sTBI patients were divided into monitoring group and non-monitoring group according to therapies with 65 patients in each group. The patients in monitoring group were given invasive intracranial pressure monitoring after craniotomy; the patients in non-monitoring group were given conventional therapy according to vital signs, conscious state and imaging data. The application of mannitol, GOS score and complications of patients in 2 groups were comparatively analyzed. Results: The application time and dose of mannitol, the incidence of electrolyte disturbance and alimentary tract hemorrhage of patients in monitoring group were obviously lower than that of patients in non-monitoring group (P<0.05). The good prognosis rate of patients in monitoring group after 3 months’ treatment was 81.54% (53/65), which was obviously higher than non-monitoring group (P<0.05). Conclusions: Dynamic monitoring of intracranial pressure with invasive intracranial pressure monitoring technique in sTBI patients is conducive to understand the illness timely, adjust the dosage drugs and improve the prognosis; so it is worthy of application in clinic.