Little is known about the long-term affects of head injury on achievement. The post-injury educational and occupational achievements of 520 survivors of penetrating head injury in Vietnam (and 85 uninjured controls) were examined 15 years after injury. Most patients (82%) had used Veterans Administration educational benefits to return to school, and many of those (64%) had achieved degrees. Return to work was strongly related to level of educational achievement, particularly among the most severely disabled. Though only 56% of the head injured were gainfully employed, the occupational distribution of those who were working differed little from uninjured controls, or the male labor force. Severity of injury affects educational achievement and return to work, but not the occupational distribution of those who do manage to return. Even the most severely injured can sometimes achieve high educational and occupational levels.