Background: Unknown patients represent a particularly vulnerable group. They are usually neglected individuals, with improper access to proper nutrition, sanitation and health care. They often harbour numerous comorbidities that are undiagnosed and untreated at the time of presentation and the management of such patients is particularly difficult. Objective: To analyze the clinical profile and outcome of patients admitted as ‘Unknown’ with Head injuries. Setting: Institute of neurosurgery, Madras Medical College. Subjects: Patient data was obtained by retrospectively from hospital records, records were perused from January 2014 to January 2019. Data was collected regarding patients admitted as ‘Unknown‘ with Head Injuries. Results: A total of 110 patients were enrolled into the study. 28 patients were found to have severe head injuries, 60 patients were found to have moderate injuries and 22 patients were found to have mild head injuries. 14 patients succumbed, 5 patients were successfully rehabilitated with their families and are on long term follow up, 61 patients were discharged to rehabilitation homes and lost to follow up. 30 patients left the hospital of their own volition. Conclusion: Unknown patients are an often marginalised, under represented and vulnerable subset of the Head Injury population. By describing the magnitude of the problem and the peculiar difficulties seen in treating these patients, we hope, to bring these individuals to the foreground and restate that they require a particularly empathetic approach.