The physical activity benefits of urban cycling could make an important contribution to health1, but safety fears prevent many people from riding.2 Because only a minority of bike crashes are investigated by police, local governments receive little feedback about the safety of the roads and cycleways they manage.3 The NSW Bike Plan 2010 contains a target to increase the share of short trips taken by bike in greater Sydney to 5% by 2016. However, meeting this target would more than double the number of cycling trips and likely increase the number of injuries. We set out to answer the following questions: can the incidence of bicycle injury crashes be measured at the local government area (LGA) level from hospital records? Is it feasible to interview people after hospital admission to understand bicycle crashes, and does this yield information about remediable hazards? Answering these questions may create a feedback loop from the health system to road authorities to make the cycling environment safer.