Seizures are a potential complication associated with traumatic brain injury (TBI), which can lead to secondary brain injury and increased risk for developing post-traumatic epilepsy. Current guidelines recommend the use of antiepileptic drug (AED) for early seizure prophylaxis in patients with TBI. Both phenytoin (PHE) and levetiracetam (LEV) have become standard of practice for seizure prophylaxis in TBI, yet the cost effectiveness is not well studied.