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The debate continues over whether a posttraumatic response occurs in those who have sustained a traumatic brain injury (TBI). The aim of this study was to investigate the incidence of acute stress disorder (ASD) in the mild TBI population. Patients who sustained a mild TBI after a motor vehicle accident (N = 79) were assessed for the presence of ASD. ASD was diagnosed in 13.9% of patients, and 5.1% were diagnosed with subsyndromal ASD. Dissociative, reexperiencing, and avoidance symptoms were found to have moderate to high predictive power. This study highlights the significant number of patients who experience an acute trauma response after TBI and raises the possibility that those with ASD denote those for whom an early intervention may prevent longer-term psychopathology. Diagnostic difficulties in defining ASD after TBI are discussed.