This special issue brings together internationally recognised experts in the field of paediatric acquired brain injury (ABI) to explore the long-term impact of ABI on adult outcomes. It is now well recognised that brain injury is a life-long condition which can lead to significant impairments across a range of cognitive, social and emotional areas. The hidden nature of brain injury means that it is a condition which is often under identified and misunderstood. Research included in this special issue attempts to highlight the many areas in which brain injuries incurred in childhood have led to poor outcomes in later life. Some of these areas include language, sleep, education, participation, standard of living and criminal justice. All of the included manuscripts call for increased training and education for those who care for children with ABI to improve long-term outcomes. We must seek to develop bespoke evidence-based interventions to support children and their families to ensure that all are given the opportunity to lead happy and successful lives.