To ascertain the incidence, characteristics, and consequences of transport-related injuries in a developing rural area, we conducted an epidemiologic survey in Ghana. Among the 9442 persons surveyed, 928 injuries were reported for the preceding year. Transport-related mechanisms accounted for 10% of these, but were more severe than other mechanisms in terms of mortality, length of disability, and economic consequences. The most common transport-related injuries were due to bicycle crashes, foUowed by motor vehicle crashes, which resulted in the most severe injuries and which involvedcommercial (83%) rather than private vehicles. Prevention strategies needto be different from those in developed nations and need to target commercial drivers more than private road users.