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Diffuse axonal injury (DAI) is a type of traumatic brain injury (TBI) that results from a blunt head injury. In this particular subtype, accelerating-decelerating motions cause white matter tract damage and preferentially impact regions including the corpus callosum and brainstem. The neurological compromise therefore relates to the severity of the axonal insult. The most common mechanism for DAI is high-speed motor vehicle accidents, and the clinical presentation is typically out of proportion to the CT findings. As a result, MRI is the modality of choice. Currently, there are limited therapeutic options, and management is identical to other forms of TBI including intracranial pressure and cerebral perfusion pressure management. As this disease is heterogeneous, survivors have a wide range of functional outcomes.