Objective: In this study we explored how neuroimaging and blood biomarkers relate to cognitive recovery in traumatic brain injury (TBI) patients. Methods: Sixteen participants with moderate to severe traumatic brain injury (TBI) were enrolled, with blood samples, MRI, and diffusion tensor imaging (DTI) collected at enrollment and six months. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Disability Rating Scale, and Montreal Cognitive Assessment (MoCA) were also administered at both time points to evaluate neuropsychological and functional outcomes. Results: Fractional anisotropy (FA) in the genu (rs = 0.937, p = 0.002) and splenium of the corpus callosum (rs = 0.955, p < 0.001) was strongly correlated with changes in RBANS - Attention scores. Fornix FA was correlated with changes in RBANS - Total (rs = 0.928, p = 0.008), and left tapetum FA was correlated with changes in RBANS - Visuospatial scores (rs = 0.964, p < 0.001). Right temporal fusiform cortex grey matter (GM) volume was correlated with changes in RBANS - Attention scores (rs = 0.975, p = 0.005). Blood biomarkers did not show significance. Conclusion: Imaging markers like FA and GM volume appear to help predict cognitive recovery in TBI, supporting the potential use of neuroimaging to guide rehabilitation strategies.