Background Road traffic injuries (RTIs) are a major public health problem worldwide; in Sri Lanka RTI cause six fatalities daily. Traffic police records are the only available National data and are plagued with under reporting and selection bias.

Objective To describe the incidence of RTI in Kandy.

Methods A community based cross-sectional survey was conducted in 2008 using stratified multistage cluster sampling. Data were collected using pretested structured interviewer-administered questionnaires. Individuals who had sustained an injury/or death due to a road traffic crash (RTC) in the preceding 12 months were included. Data was analysed with SPSS and reported in % with 95% CI.

Results Of 11 724 persons screened (n=3080 households), 149 had sustained RTI, including 16 fatalities. The annual RTI incidence was 12.7/ 1000 persons (95% CI 12.5 to 12.9), and the annual RTI fatality incidence was 1.4/1000 person (95% CI 1.3 to 1.5).The case fatality rate was 10.7%. The victims had a mean age of 28.8 years (SD=16.8) and were predominantly male (3.5 : 1).The overall rate of RTI increased with age, peaking in the 50–54 year age group (35.9/1000/year (95% CI 35.4 to 42.7). Pedestrian injuries were the most common cause of both injuries (n=51(34.2%)), and fatalities (n=9 (56.2%)), 50.0% of the deaths occurred at the scene or immediately in hospital, while 22.1%of the injured had recovered with disability for self care.

Significance There is a huge burden of RTI in Kandy district with the pedestrians, and males at higher risk for RTIs. Urgent preventive measures should be implemented to reduce this serious public health problem.