One of the most challenging aspects of caring for patients after severe brain injury is discussing prognosis with families and loved ones. This lecture will summarize existing data and recent literature surrounding prognosis and outcomes for patients who have experienced severe neurologic injuries, including subarachnoid hemorrhage, ischemic stroke, intracerebral hemorrhage, and hypoxic injury. The goal will be to provide a framework for discussing potential long-term outcomes as providers help guide families through these difficult moments.