Objectives To perform comprehensive analysis of available road traffic crash (RTC) data from 1956 to 2009 and to estimate magnitude of RTC and associated injuries and fatalities in Pakistan.

Methods Data from National Transport Research Centre and Statistics Bureau of Pakistan was analysed. Absolute number of crashes, fatalities and injuries as well as fatality risk (fatality per 100 000 inhabitants), fatality rate (fatality per 10 000 registered vehicles), injury severity and fatality per fatal crash were used as indices to measure the trends.

Result From 1956 to 2010, RTCs increased by 13 times in Pakistan (n=796 to n=10 466). The injuries increased by more than 13 times as well, from 882 to 11 865, and fatalities increased by 15 times—from 302 to 4754, over the same period. Likewise, fatality risk has increased threefold, with 1 in 1961 to 3 in 2009. However; fatality rate has decreased considerably from 58 in 1956 to 7 in 2009. Moreover, fatality per fatal crash remained stable within range of 1.3 and injury severity has increased from 0.38 in 1956 to 0.52 in 2009. The data showed inconsistent trends and considerable variations between the two data sources, which suggests that data collected by different sources are incomplete and not coordinated with other sources.

Conclusions There is a good deal of deviancy in variables of the two datasets, which suggest that there is discrepancies in data collection and dissemination process leading to compromise on data quality. Moreover, definition and classifications lack international standard. There is urgent need to improve injury surveillance system which can be capable of recording the true magnitude of the RTC and associated road fatality and injury in Pakistan so that policy makers can be able to gauge the severity of the issue which can be helpful in assigning priority to road safety Pakistan.