Traumatic scalp and forehead injuries are frequently encountered in the acute setting in Level I trauma centers. This is a Level IV Therapeutic/Care Management article describing a retrospective review that analyzed a single Plastic and Reconstructive surgeon's experience treating these injuries in patients, over an 8-year period from 2006 to 2014. Fewer complications were seen in patients treated within 7 days of injury. When treating these patients, a surgeon should possess several key attributes. The ability to perform adequate primary debridement, knowledge, and familiarity with the intricate anatomy in this region, and experience with simple and complex reconstructive algorithms—are all crucial to obtaining optimal functional and aesthetic outcomes in this anatomic region. The authors’ results support the idea that a plastic and reconstructive surgery service is an indispensable resource in the high-level acute trauma setting.