Abstract To assess transcranial color-coded duplex sonography (TCCD) as a reliable method for predicting intracranial pressure (ICP) in brain injury patients at moderate-to-high-altitude, clinical data were collected from patients admitted to the Intensive Care Unit of a tertiary hospital on the Qinghai-Tibet Plateau between April 24 and July 24, 2025. A total of 158 sets of middle cerebral artery pulsatility index (MCA-PI) and ICP data from 54 patients were included.