Objectives: To examine atomoxetine, a novel norepinepherine-reuptake inhibitor FDA approved for the treatment of attention-deficit disorder with hyperactivity in children and adults, as a neurostimulant agent for promoting arousal in a person with severe traumatic brain injury (TBI). Hypothesis: Given its powerful impact on the noradrenergic system, it was hypothesized that atomoxetine would have a significant positive impact on consciousness. Participants: A 17-year-old man who sustained a severe TBI (GCS3) with noted traumatic subarachnoid hemorrhage and diffuse axonal injury in a motor vehicle accident presenting to our brain injury rehabilitation unit in a minimally conscious state. Methods: The patient underwent comprehensive acute care rehabilitation and pharmacologic treatment for hypoarousal. Serial coma-near-coma (CNC) scores were recorded. Results: CNC scores improved minimally on amantadine and subsequently on methylphenidate (MPH). MPH was discontinued and treatment and atomoxetine (40 mg daily) was initiated on Day 22 (baseline CNC = 1.2). When atomoxetine was increased to 40 mg twice a day on day 25, significant functional improvements were corroborated via rapidly decreasing CNC scores (CNC = 0 by day 35). No side effects were noted. Conclusions: Atomoxetine may show promise as a neurostimulant agent in persons with TBI and severe disorders of consciousness.