Aims: The study was done to find out the types of injuries, modes of road traffic accidents and case fatality rate of road traffic accident cases from 1 st April 2005 to 31 st March 2010 in a tertiary care hospital. Materials and Methods: The retrospective study conducted on hospitalized patients admitted with road traffic accidents in a tertiary care level from 1 st April 2005 to 31 st March 2010. Data collected from the registers maintained in the medical records department, follows the guidelines of International Classification of Diseases-10 coding. Results: Of the 7,660 road traffic accident cases reported in a hospital from 1 st April 2005 to 31 st March 2010. Most of the cases and deaths were occurred in the age group of 15-44 years. Total deaths occurred due to road traffic accident was 249 (3.25%). Motorcycle rider injured in road traffic accident was more except other land transport accidents during the period from 2005 to 2010. Of the road traffic accident cases, fractures (42.7%) were more than superficial injuries (18.56%) and dislocations (2.6%). Conclusion: This study mentioned that most of the cases and deaths were occurred in 15-44 years. Accidents of the economically productive people will affect their family. Hence to reduce the road traffic accidents by conducting public awareness program and strict enforcement of traffic rules.