Posterior fossa Extradural haematoma (PFEDH) is a rare variety of traumatic brain injury (TBI), representing 4–12% of EDHs. It is highly fatal due to limited volume in the posterior fossa. If diagnosed early by CT scan, it can be life saving. 50 patients in Rajiv Gandhi government general hospital, Chennai were retrospectively analysed from January 2015 to December 2018. Most patients were male. Occipital bone fracture was an associated finding. The Glasgow coma score (GCS) at admission, the presence of hydrocephalus and associated intracranial injury determined the outcome. SUMMARY: 50 patients with PFEDH were studied retrospectively. Surgical evacuation was done in 20(40%). Glasgow outcome score (GOS), was favourable in 12 of the 20 cases operated (60%), and 28 out of the 30 conservatively managed group (93%). Overall favourable outcome was found in 40 cases (79%) with overall mortality of the study being 16%.