Head trauma is leading cause of mortality after injuries related with skiing and snowboarding. Wearing a helmet is considered to be a primary method to prevent traumatic brain injuries (TBI) among alpine sports participants. This article, based on literature review, determines the efficacy of helmets and safety of their use. It also presents practical principles of proper helmet fitting. A well proven reduction in the risk of TBI connected with helmet use is reported in the literature, ranging from 22 to 60%. Helmet use does not increase the risk of neck and C-spine injury. There is no good evidence to support the claim that use of helmets increases the risk compensation behaviors among participants. Proper fit includes adequate size, non-attenuated peripheral vision and hearing, well adjusted retention system (chinstrap). This factors may influence both efficacy and safety of helmet use. Helmets are recommended for all skiers and snowboarders.