Fractures of the clivus are often associated with severe head trauma and have high mortality rates due to coexisting injury of the adjacent vessels, brain stem and lower cranial nerves. An early diagnosis is often not possible because of adherent problems, high mortality rate and inadequacy of emergency imaging. Diagnosis has recently become easier with high resolution bone window computed tomography studies. In this study, radiological and clinical findings of three patients with longitudinal clival fractures and severe head trauma have been presented and associated injuries and prognostic issues are discussed with reference to the limited number of similar cases in the English literature.