In addition to the physical aspects of athletic injury, there are psychological aspects to consider. These are important during all phases of injury management: the acute injury, the rehabilitative process, and the return-to-play progression. Emotional disturbances are often associated with mild traumatic brain injury (mTBI) both directly and indirectly. Evaluating the athlete with mTBI can be made more difficult by the need to distinguish the physical and the emotional effects of injury and to differentiate the emotional factors directly related to the brain injury from those that arise indirectly (eg, reaction to being held out of play). This article discusses some of the psychological issues related to evaluating the head injured athlete.