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Understanding the biomechanics of road traffic collision injuries is important for diagnosing and managing road traffic injured patients. As road traffic collisions may entail high-energy trauma, the degree of injury will depend on the mass and speed of the collided vehicles. Collisions can be front impact, back impact, side impact; the vehicle may turn over or the patient may be ejected from the vehicle. Each of these mechanisms has a specific pattern of injury. The injury will vary depending on whether the passenger was restrained with a seat belt or not. Seat belts tend to reduce head injuries and increase the abdominal injuries. Compression injuries of the intestines and urinary bladder tend to be more severe, causing rupture of these hollow organs if pressure within these organs was high. Pedestrian injuries consist of three phases: the bumper impact, hood and windscreen impact, and ground impact. The injury pattern and impact of motor vehicle collisions with large animals will depend on the size, height and weight of the animal. Clinical examples of road traffic collision patients will highlight the value of understanding biomechanics in patient management.