•Preventable death from head injury are remains a feature in developing countries.•This is a report of two such occurrence.•We report two fatalities from scalp laceration in rural Nigeria. While outcome of head injury has improved over the years in the advanced world, the developing countries with their less than the desired health systems lag behind. In these settings, deaths often result from trivial causes including scalp laceration. We present two cases of such fatalities from mere scalp lacerations seen in a new rural neurosurgery practice in Nigeria. Both patients had no other source of significant blood loss. These patients had been to some peripheral hospitals but were merely referred for ‘expert neurosurgical care’without any attention to the scalp lacerations. Both patients arrived at the accident and emergency department of our health facility hours after the trauma in extreme conditions and subsequently died within minutes of arrival before they could be fully resuscitated. Though eminently treatable and complications preventable, scalp lacerations remain a highly preventable cause of death in rural health services of developing countries.