Researchers examined how tranexamic acid affects the outcomes of patients with traumatic brain injury (TBI). In this randomized, placebo-controlled trial, they included 12,737 patients with TBI who were within 3 h of injury, had a Glasgow Coma Scale (GCS) score of 12 or lower or any intracranial bleeding on CT scan, and no major extracranial bleeding at 175 hospitals in 29 countries. Patients were randomly assigned (1:1) to receive either tranexamic acid (loading dose 1 g over 10 min then infusion of 1 g over 8 h) or matching placebo. Outcomes support the safety of providing tranexamic acid to patients with TBI. Providing tranexamic acid within 3 h of injury led to a reduction in head injury-related death. After the injury, treatment should be provided as soon as possible to the patients.