Background High rates of serious road traffic crashes (RTCs) have been reported in several Arabian Gulf countries, including the United Arab Emirates (UAE), in recent years. In 2013, in a population of approximately 9.2 million, 7734 people were seriously injured and 651 (7.8%) died from road traffic injuries (RTI). Hence, the problem constitutes a major concern for public health in the UAE. The study aims to determine the trends of RTI in the UAE, to identify the causal factors of the problem and to review the most cost effective measures to mitigate their impact. Other objectives include estimating the future forecasts of RTI and assessing the economic burden of the problem on the population.

Methods Data from official UAE sources were used for the analysis. To identify RTI trends of morbidity and mortality during 2000–2013, time’s series analysis was used. To forecast RTI fatalities in the UAE, regression analysis was used. Analysis of variance (ANOVA) was used to estimate overall and individual significance of regression parameters. To quantify the economic burden of RTI in the UAE, the Human Capital (HC) approach was used to estimate the direct and indirect economic losses from RTI during 2013. For pain, grief and suffering (PGS) willingness to pay value estimates (WTP) were derived worldwide and adjusted for the UAE.

Results The rates of RTC in the UAE were found declining on constant basis. Likewise, trends of morbidity and mortality and future forecasts from RTI were also declining. Paradoxically, however, the severity of RTI was constantly increasing. The total cost of RTIs in the UAE varied between AED 22–23 billion during 2013, representing 1–2% of its GDP for that year (US$ 401 billion).

Conclusions Speeding, vehicles’ mix, the competency of young drivers, the standard of medical care for victims at the roadside and the efficiency of traffic regulations and measures, are suspected for the paradoxical patterns, but the precise reasons remain to be determined. The study provides a useful base for establishing priorities for future roadway traffic safety interventions in the UAE.