Nonsurvivors of traumatic brain injury (TBI) are known to exhibit higher levels of caspase-3 in contused brain tissue than do survivors. Now, Lorente et al. report that serum caspase-3 levels are also linked to increased mortality. Caspase-3 inhibitors have been shown to reduce apoptosis in rat models of TBI, making suppression of apoptotic activity a potential novel strategy to treat TBI.