head and brain with a variety of complications that can even lead to death. In head injury patients who experience a decrease of consciousness, the ability to maintain airway is also reduced so the medical help that can be given is a tracheostomy. Tracheostomy as a medical measures that aim to maintain the airway so that air can get into the lungs and bypasses the upper airway by opening the anterior trachea. Tracheostomy can be classified as early and late tracheostomy. Aim: To determine the relationship between early tracheostomy with increased glasgow coma scale and acceleration of a mechanical ventilator weaning in patients with severe traumatic brain injury. Method: This study was an observational analytic study with cross sectional design. Samples are collected with purposive sampling method. There are 67 samples that has been selected through inclusive and exclusive criteria. Data was gathered from medical record at PKU Muhammadiyah Yogyakarta Hospital within period December 2015 - February 2016. Data was analyzed with Mann Whitney Test and Fisher's Exact Test. Results: Of the total 67 samples, early tracheostomy was performed on 30 samples of which 19 samples are given a mechanical ventilator and slow tracheostomy was performed on 30 samples of which 17 samples are given a mechanical ventilator. Time of increased glasgow coma scale in patients with severe traumatic brain injury that has been performed early tracheostomy and slow tracheostomy have been analyzed statistically using Mann Whitney Test and Fisher's Exact Test showed p value = 0,000. In addition, the duration of use mechanical ventilation in patients with severe traumatic brain injury that has been performed early and late tracheostomy that have been analyzed statistically using Mann Whitney Test showed p value = 0.000, whereas that have been statistically analyzed using Fisher's Exact Test showed p value = 0,003. Conclusion: There was a significant correlation between early tracheostomy with the average time of an increase in the glasgow coma scale and duration of use mechanical ventilation in patients with severe traumatic brain injury.