As a result of a review of the available literature and some unpublished sources, data on ante mortem cranial trauma have been gathered for 25 archaeological sites from Mesopotamia, dated from the Pre‐Pottery Neolithic to the modern period. In total, 31 healed cranial lesions have been noted in 28 out of 1278 individuals, and the general frequency of this condition was 2.2%. Both men and women were affected, with no clear preference noted, and sharp‐force trauma was rare; therefore, intra‐group violence and accidents were more likely causes of most lesions than military activities. The frequency of ante mortem trauma was higher in earlier periods (before the end of the third millennium BCE); the size of lesions increased with time, and healed lesions were more common in the northern periphery of Mesopotamia than in the core area. All this may be the consequence of early state formation and the establishment of professional armies, which made most farmers and city dwellers less involved in violent conflicts than in other parts of the Near East where the observed frequency of violence‐related injuries was much higher than in Mesopotamia. Copyright © 2015 John Wiley & Sons, Ltd.