The present study was performed in patients with EDH in order to define the clinical outcome of EDH evacuated through a single burr hole. █ MATERIAl and METhODSThis descriptive study was performed in the Department of Neurosurgery, Ayub Teaching Hospital (ATH), Abbottabad, Pakistan from 8 th October to 12 th October 2005, during the earthquake. ATH is 1000-bed hospital with a well-established unit and serving about 7 million population. We had two qualified neurosurgeons at the time of the earthquake. On the first day of the earthquake 18 patients were operated for EDH, followed by 13 patients on the second day and 6 patients on the third day. █ INTRODUCTIONHead injury is a major health problem. It is reported that 1% of all deaths and 15% of deaths occurring between 15 and 24 years are secondary to head injury (12,16). The major cause of preventable deaths in head injuries is a delay in diagnosis and treatment of intracranial hematomas (16,20).Deterioration of conscious level and developing focal neurological signs signify a rapidly growing extradural hematoma (EDH) (16). In these cases, an urgent computed tomography (CT) scan will reveal biconvex hyperdense EDH causing effacement of the ventricle and midline shift. Craniotomy/craniectomy and evacuation of the hematoma is the treatment of choise to save the life of these patients (16). AIM:To observe the outcome of burr hole evacuation of extradural hematoma (EDH) in mass head injury. MATERIAl and METhODS:This study included patients of any age who sustained head injury in the earthquake of October 8, 2005, were diagnosed as EDH on computed tomography (CT) scan and were admitted in the neurosurgery ward over a period of 3 days. All patients were followed by serial CT scans and neurological assessments. RESUlTS:A total of 36 patients were included in this study. There were 25 male and 11 female patients and the age range was from 5 years to 50 years. All cases were the victim of the earthquake. All patients underwent surgery for evacuation of EDH through a single burr hole. One patient required craniotomy for EDH due to neurological deterioration on the second postoperative day, and 1 patient died. CONClUSION:As EDH is potentially fatal lesion, evacuation of EDH through a single burr hole has good outcome with less chances of recurrence and complications in mass head injured patients as seen with earthquakes.