The frequency of head injury in a representative sample of crashes in the Adelaide metropolitan area is presented in relation to the type of road user and the type of accident. The accident risk factors that are particularly associated with head injuries are discussed. The nature and severity of the head injury is then related to the characteristics of the object struck. The consequences of these head injuries are presented in terms of the duration of hospitalisation and subsequent period of restricted activity together with the extent of any residual disability. These measures are compared with those for injuries to other body regions to indicate the relative importance of injuries to the head in an environment of compulsory seat belt wearing and helmet wearing by motorcyclists. The paper concludes with a discussion of the possibilities and priorities for the prevention of head injury in urban traffic accidents.