Hypertonic saline (HTS) is an osmotic agent that can help patients in the acute phase of severe traumatic brain injury. HTS extracts fluid from swollen cerebral tissue to both control intracranial pressure and diminish the deleterious effects of secondary brain injury. Neuroscience nurses in intensive care and acute care units, who may administer HTS as resuscitation fluid, continuous infusion, or bolus dose, need to be familiar with physiologic actions, potential side effects, and appropriate HTS administration techniques. Neuroscience nurses collaborate with other members of the interdisciplinary team to ensure that HTS is administered safely.