BACKGROUND:: Dural repair material for the anatomic integrity of the dura mater is necessary, and the dural repair materials in clinic are artificial menigeal tendon. OBJECTIVE:: To investigate the effect of menigeal tendon for dura mater repair and dura mater opening on the prognosis and secondary cranioplasty during standard large trauma decompression. METHODS:: Retrospective analysis was conducted in 220 patients with severe traumatic brain injury undergoing standard large trauma decompression and 93 patients undergoing cranioplasty. Patients admitted before 2004-12 were selected as dura mater opening group, and those after 2005-01 as menigeal tendon group. RESULTS AND CONCLUSION:: Among 108 cases in the dura mater opening group, there were 3 cases of intracranial infection, 11 of epilepsy, 12 of subdural effusion, 7 of cerebrospinal fluid leakage, 18 of encephalocele, 44 cases of secondary cranioplasty. In the menigeal tendon group, there were 1 case of intracranial infection, 5 of epilepsy, 4 of subdural effusion, 2 of cerebrospinal fluid leakage, 7 of encephalocele, 49 cases of secondary cranioplasty. Standard large trauma decompression plus menipeal tendon repair can dramatically reduce the occurrence of complications and secondary cranioplasty rate.