Background- Human, vehicular and environmental factors play role before, during and after a Road Traffic Accidents. Accidents occur not only due to ignorance but also due to carelessness, thoughtlessness and over confidence. Aim- The study aimed to analyze pattern and incidence various injuries sustained by RTA victims will be carried out. Methods- The present cross sectional study was carried out at Department of Forensic Medicine of a tertiary care teaching institution from rural Chennai. All the deaths due to road traffic accidents occurred at RIMS, Chennai during the period 2011-2013 were retrospectively analyzed. The detailed analysis of these cases was based on the inquest report, medical records and evaluation of autopsy reports. Results- Out of 1108 medico legal autopsies... conducted during the study period, 302 (27.2%) were of vehicular accident fatalities. Maximum numbers of fatal vehicular accidents were reported on Saturdays followed by Fridays and Sundays. The majority of male victims were found in the age group (>10-40 years) with a percent of 55.2%. The lowest percentage of both male and female victims was in the age group (<10 years) which represented 3.9% and 2.0% respectively, which is statistically non-significant. A large proportion of the victims (34%) died on the spot/ brought dead or died within 1 hour of the accident. Nine percent cases survived up to 7 days whereas only 7.5% cases survived beyond 1 week. Skull fractures were found in 60.9 % cases of head injury. The commonest variety of intracranial haemorrhage was subarachnoid haemorrhage (60.9%). Conclusion- Findings of this study highlight that most of the deaths in road traffic accidents, brought to a tertiary care hospital in rural Chennai, take place either on the spot or within 24 hours of injury which shows need of good pre-hospital care and provision of quality trauma services at site in India.