Aim: To study the importance of routine follow–up CT Brain at 24hrs and 48hrs in clinically stable mild head injury patients in picking up silent increase in size of hematomas and its influence in altering the management protocol and its cost effectiveness. Materials and methods:This is a prospective type of study including 235 patients with mild head injuries admitted in a tertiary care centre near chennai. CT brain was done at the time of admission and the nature of injury recorded. Routine follow–up CT Brain taken at 24hrs and 48hrs after the time of head injury irrespective of the time of initial CT Brain. The patients were clinically monitored for any signs of increased ICP or neurologic deterioration and the radiological progression assessed. Observation: Increase in size of hematomas & fresh hematomas are observed in 9% of patients studied, which altered the treatment protocol. Routine CT scans picks up progression of hematomas even before patient deteriorates. Conclusion: Though the role of routine follow–up CT brain in mild head injury patients without any clinical deterioration is still contentious, it should be considered wherever possible. Routine CT scan may not be cost effective but for those families for whom it has altered the management & saved their loved ones it matters most