Aims: To determine patterns and outcomes of pelvic injury resulting from motorcycle and car accidents. Methods: Review of the records of 233 patients (151 male, 82 female, median age 31(6–91) years) admitted to a teaching hospital (1996–2001) with pelvic injuries resulting from a road trafþc accident. Results: Ninety-One (39.1%) car occupants (53 drivers, 23 front and 15 rear seat passengers) and 57 (24.5%) motorcyclists (52 riders, 5 pillion) sustained pelvic injuries. Both groups had similar median ages (27.0 years (15–81) and 33.7 years (12–72)) and mean Injury Severity Scores (23.0(4–75) and 20.4(4–57)) respectively. Motorcyclists more commonly sustained pelvic fractures associated with major blood loss (18% vs 9%) and fractures more commonly involved the sacro-iliac joint (40% vs 24%). Head*, facial* and thoracic* injuries predominated in car occupants and extremity injuries in motorcyclists. Two (2%) car occupants and 2(4%) motorcyclists died. Operative procedures were required in 49(86.0%) motorcyclists and 67(73.6%) car occupants. Thirty (52.6%) car occupants and 28(30.8%) motorcyclists required pelvic surgery. The median hospital stay was 19(1– 93) and 20(1–93) days respectively. Conclusions: Patterns of pelvic and associated injuries differ markedly between car occupants and motorcyclists reßecting differing injury mechanisms. Although pelvic injuries sustained in car and motorcycle accidents have a relatively low mortality rate they are associated with a high incidence of injury to intra-abdominal and intra-pelvic organs. Understanding common patterns of injury associated with pelvic trauma is vital in their prevention and management. (*P< 0.05)