One hundred and sixty victims of motor vehicle accidents presenting to Auckland Hospital were evaluated to determine patterns of injury, overall injury severity, and outcome. Motor vehicle occupants comprised 51% of the group, pedestrians 28% and motorcyclists 21%. Mortality was 7.4%, 20% and 2.9% respectively for these three groups. The mean injury severity score was 19. Head and external injuries were common, each occurring in over 60% of all patients. In motorcyclists however, head injuries were less common (47%) (p less than 0.05) and facial injuries occurred in only 9% compared to 23% (p = ns) of the other two injury groups. Overall, severe chest or abdominal injury was present in only 16% of patients but these injuries occurred in 58% of those patients with severe head injury and extremity fractures (p less than 0.001). In motor vehicle occupants the combination of severe head injury and lower extremity fracture was associated with severe chest or abdominal injury in 8/9 patients. The patterns of injury identified here may be helpful in triaging patients to appropriate care facilities.