Objective Injury and violence cause 5 million deaths annually in the world which is around 9% of the global mortality. Eight out of 15 leading causes of deaths in the age group 15–25 years are injury related. The study investigates the incidence, severity and socio-economic burden of injuries and violence in two cities of Nepal.

Design A cross-sectional study was designed to record the incidence of injuries, their causes and socio-economic burden during 17th August 2008 to 16th September 2008.

Participants The study was conducted in emergency department of six hospitals in two major cities of Nepal. All the patients visiting emergency department with any kind of physical injury were included into the study.

Outcome measures The cause, circumstances and severity of injury were recorded. In addition, the total amount of expense for the treatment was also calculated.

Results In total, 505 injury cases (two brought dead) were reported, 72.7% (n=367) were male. Majority (60%, n=303) of them were economically active. 10.5% (n=53) were severely injured. 42.5% (n=214) of the injuries occurred in roads and 34.1% (172) at home. 65% (n=115) of road traffic injuries involved motorcycles. Fall from height (30.4%, n=503) was the commonest domestic injury. A single injury case cost 126.2 US$ including all the expenses and the loss due to inability to work.

Conclusions The high incidence of injuries, especially road traffic injuries, adds a huge economic burden to nation.