Falls are a significant cause of traumatic brain injury (TBI). There has been little research into falls resulting in a TBI in adults under the age of 60. The authors retrospectively analysed consecutive referrals to their community rehabilitation service between 2009 and 2012 in order to determine whether falls are a common cause of TBI in adults under 60, the different types of falls, the presence of alcohol at the time of the fall, and return to work following TBI. Falls accounted for 25 % of TBI. Ground-level falls and falls down stairs were the main causes of falls leading to TBI. Alcohol was present in 30 % of the falls. 44 % of individuals who had been working prior to their fall related-TBI had returned to work 1 year post-TBI. The authors conclude that falls amongst adults under sixty is an important cause of traumatic brain injury, and requires preventative and reduction strategies.