Background Studies have suggested considerable injury mortality in India, a large proportion of these is due to unintentional injuries. However no reliable data are available to provide national estimates for these deaths.

Objective To determine the mortality burden of unintentional injuries at a national level.

Methods We analysed unintentional injury data from the Sample Registration System – Million death study from 2001 to 2003, using verbal autopsy method, in a nationally representative sample of over 125 000 deaths among 1.1 million homes.

Findings Unintentional injuries (ICD-10 codes for Chapter XX) were identified and contributed 7% to all cause mortality. Proportionate mortality was highest in the age group of 70+ years, with more than 60% injury deaths due to falls, although there is also greater misclassification of causes at older ages. The highest proportions of drowning deaths were in under 5 years (14%), the highest proportion of road traffics deaths were in the age group of 30–39 years (10%) of all unintentional deaths. Proportionate mortality due to unintentional injury in males (8%) was higher than in females (5%). Overall there was no difference in rural urban proportionate mortality, though type of injury leading to deaths differed. Road traffic injuries (29%), falls (26%) and drowning (11%) were the leading causes of injury mortality.

Interpretation Unintentional injury burden in India is substantial. There is need for continued monitoring of injury mortality and understanding of specific risk factors for development of effective injury prevention programs.