There had been 105 fatal cases among 430 head injury emergency cases (including 23 CPAOA cases) from 2000 to September 2004. The PTD (preventable trauma death) cases among these fatal cases were reviewed through classification into three groups of Ps<0.25, 0.25<Ps<0.5 and Ps>0.5 by Ps (possibility of survival) values measured by a TRISS method. As a result, there were 60 cases of Ps<0.25, 29 cases of 0.25<Ps<0.5 and 26 PTD cases of Ps>0.5, and the PTD rate was 28%. Most PTD's were single, severe head injury cases among middle-aged and elderly patients. However, when the cases of death were examined, it was discovered that many cases involving a difficult rescue were included among them. Further investigations, including the assessment method for the preventable cases among severe head injury cases, are considered necessary.