Traumatic brain injury guidelines of two well-known sources were selected for adaptation in Iran. In this brief report, we aimed to highlight our modifications according to domestic situation of a developing country. The guidelines were selected using the AGREE (Appraisal of Guidelines for Research & Evaluation) instrument. Fourteen Iranian expert neurosurgeons reviewed all key recommendations, related levels of evidence were evaluated and possible revisions were considered. Following items were the most challenging which were modified according to domestic situation: Age as a risk factor for referral or computed tomography scan, medical comorbidities and pregnancy, consultation and referral to a neurosurgical unit, teleconsulting and observation before discharge. Modifications in these topics were done based on experts views and very limited and controversial evidences. This report underlines the importance of further studies in Iran to fill the current knowledge gap.