OBJECTIVE To assess the contribution of Road Traffic Accidents (RTAs) to neurosurgical mortality in adults. DESIGN It was a descriptive study. PLACE AND DURATION OF STUDY The study was carried out at Pakistan Institute of Medical Sciences (PIMS), Islamabad. from June, 1998 to June, 2002. PATIENTS AND METHODS The clinical records including radiological records and death certificates were studied. Absolute and relative frequencies of neurosurgical mortality were noted. Mean age and male to female ratio of the patients who died due to RTAs were also determined. RESULTS There were 315 post-traumatic deaths. RTAs contributed to 281 deaths while head injury was the cause of death in 268 patients. A significant number of patients died below the age of 40 years (63%) and male to female ratio was 6.8:1 secondary to RTAs. CONCLUSION RTAs are a major contributor to neurosurgical mortality especially in adults. RTAs are one of the preventable causes of neurosurgical deaths.