To address concerns about self-awareness deficits and the validity of self-ratings by patients with head injury (HI), the current study examines mean differences and correlations between self-ratings from 52 patients with HI and ratings of the patient by informants using the revised NEO Personality Inventory (NEO-PI-R). Patient self-ratings were significantly lower than informant ratings on neuroticism and extraversion and significantly higher on conscientiousness. Patient-informant correlations ranged from .42 for conscientiousness to .67 for agreeableness, and these agreement correlations compare favorably with those obtained from normal adult samples. Hierarchical multiple regression equations for each of the five NEO-PI-R trait domains showed that more severe injuries were associated with higher agreement for extraversion. For all five traits, the strongest predictors of informant personality ratings were the patients' self-ratings. The implications of these findings for clinical assessment and improved research on self-awareness deficits after HI are discussed.