The presence of an alpha pattern on electroencephalography is well described in patients with coma following trauma, hypoxia, metabolic dysfunction and cardiorespiratory arrest. This is generally regarded as an adverse prognostic factor especially the non-reactive complete form. We report a 15-year-old girl with complete alpha coma following head injury, who subsequently made a good physical recovery. We believe that this case should help pediatric neurologists, intensivists and neurophysiologists in the future, who have to make difficult management decisions and will inform their discussions with the child's parents or guardians.