This study aimed to investigate the association between the plasma levels of high-mobility group box-1 (HMGB-1) and galectin-9 (Gal-9) and patient outcomes in severe trauma cases. We conducted a prospective observational study involving 78 patients with severe trauma admitted to a tertiary care emergency center, including 10 patients who died within 28 days post-admission. Blood samples were collected on days 1, 2, 3, 5, and 7 after admission, measuring plasma HMGB-1 and Gal-9 levels. HMGB-1 was highest on day 1, followed by a rapid decline within 24 hours, remaining elevated compared to normal levels. Conversely, Gal-9 peaked on day 1 but returned to normal within 48 hours. HMGB-1 levels demonstrated a significant ability to distinguish between survivors and non-survivors, with a moderate diagnostic power (AUC 0.7213), as shown by the receiver-operating characteristic (ROC) analysis. Combining HMGB-1 with other biomarkers, such as lactate and base excess, improved the specificity, indicating the potential utility of HMGB-1 as a prognostic biomarker for trauma-related mortality. Gal-9, however, showed no predictive value for patient outcomes in this cohort. These findings suggest that while HMGB-1 holds promise as a biomarker for assessing mortality risk in trauma patients, Gal-9 in its full-length form may not be suitable for prognostic use. Further studies with a larger patient sample are recommended to validate these findings and explore the use of specific molecular forms of HMGB-1 and Gal-9 in clinical settings.