Road traffic injuries (RTIs) are a leading cause of morbidity, disability and mortality in less developed countries. Globally in 2002, 1.2 million deaths resulted from RTIs, and about 10 times that were injured. RTIs are often preventable, and the technology and knowledge to achieve success in this area exist. In spite of this, it is projected that given the current trend and without adequate intervention, RTIs will rank third of all major causes of morbidity and mortality globally by 2020. Although > 85% of the global deaths and injuries from road traffic crashes occur in less developed countries, traffic safety attracts little public health attention in these nations, due in part to a plethora of other equally important problems, including infectious diseases. Unfortunately, the public health and economic impact of traffic-related injuries and disabilities can be incalculable in these countries, owing to their poorly developed trauma care systems and nonexistent social welfare infrastructures to accommodate the needs of the injured and the disabled. In this paper, we highlight the problem posed to public health in less developed countries by RTIs and examine contributing factors. To engender debate and action to address the problem, we reviewed interventions that have proven effective in industrialized nations and discussed potential barriers to their replication in less developed countries.