This study presents the results of a systematic review of the literature concerning the most significant issues surrounding pragmatic intervention for adolescents with moderate to severe traumatic brain injury (TBI). Although TBI may cause substantial pragmatic deficits at a very sensitive phase of social development in an adolescent, little research exists regarding specific treatment protocols for this problem. The purpose of this systematic review was to use the information from the research to design a pragmatic intervention protocol for this population to promote school re-integration and the achievement of long-term vocational goals. A systematic review of the research in peer-reviewed journals from 2000-2014 was conducted with electronic databases and printed periodicals available through Rockhurst University. All studies meeting the inclusion criteria were coded for quality and level of evidence. The review identified 10 studies relevant to the topic at hand, addressing such areas as social cognitive deficits in adolescents with TBI, differential brain activation in this population and qualitative aspects of social life for an adolescent after a TBI. The resulting protocol is a multi-dimensional approach to the pragmatic deficits most common after TBI in an adolescent with the ultimate goal of school re-integration and the achievement of long-term vocational goals. Testing of this protocol as well as research concerning possible alternative approaches is needed to fill the gap in the literature regarding pragmatic intervention for adolescents with moderate to severe TBI.