Introduction Hospital data underestimate the incidence of non-fatal injuries.

This study is a household survey to estimate the annual incidence and out of pocket medical expenses of non-fatal injuries in capital of Iran with a population of 7.9 million.

Methods A random sample of Tehran households were selected by clustered sampling. They were asked to report injuries happened to household members during the last year and also report related out of pocket medical expenses.

The clustered structure of sampling was taken into account during the analysis; confidence intervals were calculated assuming Poisson distribution.

Results 9100 inhabitants were included. The annual incidence of all injuries was 188.7 (179.9 to 197.8), injuries needing medical care was 68.8 (63.5 to 74.4), fractures was 19.3 (16.6 to 22.4) and injuries resulted in hospitalisation was 16.7 (14.2 to 19.6) per 1000 population. The annual incidence of fatal injuries was 33 (7–96) per 100 000 population.

The injury pyramid was 1/50/646 (Death/Hospital admission/All injuries).

The mean out of pocket medical expense for injuries was 16.1 USD.

Home was the place that most of injurious accidents had happened. Injuries needing medical care mostly happened in the streets and highways.

Falls followed by transport accidents were the most common causes of significant injuries.

Conclusion Non-fatal injuries impose about 27 billion USD out of pocket medical cost to Tehran population annually. Mandatory safety standards for houses should be considered by civil authorities.