Introduction: Earlier studies from the developing countries as well as from other terrains of Bangladesh showed various aetiologies of head injuries. However, there is no substantiative government data’s are available regarding the cause and manner of head injury. Objective: The current study was conducted with an objective to determine the aetiological pattern of head injury in the region. Materials & Methods: The study was conducted in Dept. of forensic medicine, Rajshahi Medical College Hospital, Rajshahi, Bangladesh from June-2019 to July-2021. Cases of fatal head injuries irrespective of their aetiology that were brought for medicolegal autopsies over a period of two years were included in this study. The data with regard to their age, sex, mode of injury in detail was collected and interpreted. Results: Out of total 59 cases of fatal head injury who succumbs to death, 90% were males. Maximum numbers of cases (27.11%) were in age group of 21-30 followed by 31-40 year (22.03%). Roadside accident was the leading cause of head injury (65%) while only 15% were as a result of assault. Two wheeler riders comprises of 35.31% followed by pedestrians (24.3%). Maximum number of fatalities due to head injury was due to roadside accident and that too in a productive age group of 21- 40 years. Rider two wheelers and pedestrian were involved in majority. Conclusion: To minimize the morbidity and mortality resulting from head injury consequent to road accidents there is a need for better maintenance of roads, strict enforcement of traffic rules, compulsory wearing of crash helmets by two wheelers along with imparting of compulsory road safety education to school children from primary education level.