Head injury forms the most common and serious form of trauma seen in India. Though data in India as a whole is sparse it does seem appropriate to say that mild to moderate head injury seems to form the major bulk of head injuries. Many such patients with normal CT scans who are discharged after a short period of ICU stay experience cognitive deficits, reduced attention spans and have problems with "executive functions" like planning, problem solving, abstract reasoning, judgment making etc. Some patients also have language deficits, problems with driving, hand eye coordination, behavioral changes and many other minor problems which may take a long time to recover. Most of these functional abnormalities are probably due to diffuse axonal injury. Axonal injury is one of the common pathological entities in any severity of head injury and is a diagnosis of exclusion for almost all of the clinical symptoms which cannot be explained otherwise. A case has been illustrated in this regards. The review throws light on the pathophysiology and some recent advances in imaging and treatment modalities of traumatic axonal injury due to mild to moderate head injury.