The circumstances of a rural and urban sample of fatalities in vehicles less than six years old is described. The data originate from an in-depth, multidisciplinary study of accidents conducted in England since 1983. The sample is biased towards collisions that result in occupant injury, and this paper will concentrate on those accidents in which an occupant has been fatally injured. The initial police reporting of the fatalities included 11% of the deaths occurring from natural causes. Of the crash-related deaths with complete data, some 43% were frontal and lateral impacts, and they are analysed in greater detail. Thirty-six percent of restrained occupants died in lateral collisions. In both frontal and lateral crashes, large amounts of intrusion result in direct loading of the head and chest, particularly. Under-run crashes with large trucks constitute 30% of frontal death cases, and only 12% of fatalities received fatal injuries from belt loads. Of those cases, additional loading by unrestrained rear passengers could have been an important feature. Multiplicity of severe injuries is the rule for restrained fatalities, with head injuries as the most common cause of death. Eighty-two percent died within an hour of their crashes. Some consequences for vehicle compatibility in crashes are discussed.