Background: Globally, road traffic accident is the 9th leading cause of death in 2004. We carried out a study of pattern of injuries in fatal cases seen in our peculiar environment to provide a baseline data for subsequent comparison in future studies and help in appropriate application of preventive efforts. The aim of the study was to determine the pattern of injuries seen in fatal cases of road traffic accidents in OAUTHC, ILE-IFE from 2000-2009. The objectives were to determine the pattern of injuries seen in RTA fatalities, to determine the types of victims (Pedestrian, passenger or motorcyclist), to determine the cause of death and to relate the above findings with age and sex of the victims. Method: We retrospectively reviewed files of road traffic accident cases autopsied at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria from 2000 – 2009. Data on age, sex, position of victim, type of vehicle, place of accident, cause of accident and pattern of injuries sustained were extracted using a proforma. Relevant photographs were taken. The information obtained was analyzed using SPSS 15.0.