Background Road traffic injuries are the twelfth leading cause of mortality globally. Nepal, one of the least developed countries in the world, has a rapidly rising rate of road traffic related morbidity and mortality. There is incomplete reporting of traffic crashes for Nepal in the last three WHO global status reports on road safety. Together with poor-quality coding of crashes, essential information to inform prevention interventions or make international comparisons is lacking.

Objective The study aimed to critically analyse routinely collected traffic police data in Makwanpur District, Nepal, to identify the road user groups most likely to be involved and injured in traffic crashes in this part of the country.

Methods This study utilised the road traffic crash records from the District Traffic Police Office, Makwanpur over two years (April 2017 – March 2018 and May 2019 – April 2020). Data were extracted from paper-based records onto an electronic database, and data analysed descriptively using Statistical Package for the Social Sciences (SPSS) version 24.0.

Results There were 291 crashes recorded in 2017/2018, and 435 crashes in 2019/20. Two-wheeled vehicles (motorcycles/scooters) were the most frequently involved in police-reported crashes (35.5%). For most crashes (419/726, 58%), no cause was documented in the police record. Road users involved in crashes were mostly riders or passengers of motorized two/three wheelers (33.4%), four-wheeled vehicles (19.9%) or buses (16.7%). Of fatal injuries, 31.2% were riders or passengers of motorized two/three wheelers, and 24.8% were pedestrians. In most crash records, there were missing data, limiting the ability to determine contributory factors with confidence.

Conclusions This study contributes to the evidence gap by describing crashes and mortality data by vehicle type and road user category. The findings suggest that the number and rates of crashes may be increasing over time. To better understand the apparent increase in crashes an analysis over a longer period, and over multiple districts, would be necessary. A new web-based Road Accident Information Management System has the potential to improve the quality and completeness of data routinely collected by the traffic police.