The number of fatal road accidents in Papua New Guinea has risen by more than 400% between 1968 and 1978. Papua New Guinea now has over thirteen times as many fatal road accidents per 10,000 registered vehicles as Great Britain. The Highlands show fatal accident rates about three times higher than those for Papua New Guinea as a whole. Of 121 road accident victims coming to post-mortem in Port Moresby between 1975 and 1978, two-thirds were young adult males. Deaths were nearly equally divided between passengers and pedestrians with drivers forming only 16% of the total. Post-mortem blood alcohol levels were above 80 mg% in 42% of the victims tested and very high levels were found in a third of the drivers. A plea is made for safer passenger vehicles, the use of seat belts and the introduction of breath testing for alcohol, along with public education to reduce the toll of accidents.