When the brain is injured there is a cascade of cellular events that can both seriously compromise the functioning of the brain and stimulate reparative processes that underlie eventual functional improvement. The likelihood and intensity of these cellular changes vary with the age of the individual. In particular, there are times during brain development, which begins in utero and continues well into the third decade of life, when brain injury may lead to strikingly different outcomes. These critical periods are related to the varying maturational events occurring at different stages of brain development.Brain damage results in lost functions that do not completely return after injury. The brain is capable of compensatory change, however, thus allowing at least partial restitution of function, the extent of recovery varying with the precise developmental state of the brain at the time of injury. Thus, although some compensatory change is possible in the brain at any age the best outcome from cerebral injury occurs after damage during the period of maximal synaptogenesis, which is in the first two years of life in humans. The formation of new synapses provides a mechanism to modify the remaining cerebral circuitry, which in turn allows each neuron to increase its processing capacity. Although it is uncommon, in certain restricted cases the brain also may generate new neurons that can be integrated into the remaining brain and support functional recovery. Treatments that increase synaptogenesis or cell generation will enhance functional recovery and events that reduce synaptic formation will retard recovery.When the brain is injured in adulthood there is a loss of function followed by a prolonged period during which there is partial recovery of some types of cognitive and motor functions. The extent of functional recovery varies with age and although injury to the infant brain can have less severe consequences than similar injury in adulthood, there are times during development when injury is especially devastating. These differences are related to the details of anatomical changes at different stages of brain development. The difference in functional outcome after injury at different ages is related to the injury-induced changes in neuronal structure, changes that are referred to as plastic changes. These plastic changes are similar to the neural and glial changes that are associated with learning in the normal brain. Various factors, such as experience, hormones, and drugs modulate these plastic changes. Even these factors cannot completely restore lost functions because there are limits to brain plasticity.