Introduction: Road traffic injuries are one of the leading causes of death in the world. Among all traffic accident, road traffic accidents claim largest toll of human life and tend to be the most serious problem world over. Accidents today are among the leading cause of death. In some countries road traffic accidents are number one cause of deaths; especially in many parts of the world particularly the more highly industrialized nations. Objective: To evaluation of pattern and distribution of injuries among road traffic accident cases. Methods: Our study done at Forensic Medicine Dept. Dhaka Medical College Hospital, Dhaka, Bangladesh from July-2015 to July-2017. This study included 501 cases of road traffic accident victims of fatal road traffic accident, brought for medico-legal postmortem examination. Results: Highest number (33.13%) of fatalities occurred in the 25-44 years age group followed by the age group 15-25 years (22.95%). Male victims outnumbered female resulting in male to female ratio of 1.8:1.Pedestrians was most vulnerable accounting for 35.93% of total fatalities followed by motorized two wheelers 30.94%. Heavy Vehicles were found to be mostly involved 56.02% of cases and most accidents 83.23% occurred on highways. Majority of cases sustained multiple injuries. Largest number of injuries was recorded in head & neck 425 number, followed by lower extremities 325 number. Vehicle occupants mostly sustained thoracic injuries. In majority of cases, the site of initial impact of the responsible vehicle was frontal followed by rear and side. Conclusion: The whole data was analyzed for pattern and distribution of injuries. Males constituted a large number of the victims of the carnage. Most of the victims were either illiterate or had education only up to schools level. Four or more wheelers, heavy vehicles, were involved in maximum number of accidents. Majority of the victims sustained fracture followed by laceration, abrasion, and contusion. ............