Trauma to the Thorax is the second most common injury found in trauma patients . Thoracic trauma causes up to 25% of deaths in trauma victims. The present study is carried out to analyze the pattern and severity of chest injuries in fatal road traffic accidents  so as to add further knowledge in the evaluation of chest trauma. A descriptive study was conducted at the department of forensic medicine, Osmania Medical College, Hyderabad. Study was conducted during the period of 1 year . And a sample of 161 cases of chest injury were analyzed.128 had rib fractures on left side and 121 on right side. Fracture of clavicle accounted for one in 20 of all fractures and 44% of all injuries to the shoulder girdle.  5 cases showed fracture of scapula either on one side or both. On the right lung , the middle and the upper lobes together form the common site of pulmonary contusions and on the left lung 23.6 % of contusions are present on upper lobe. Cardiac contusions were found in 34 cases and the usual site was in the right ventricle followed by the right Atrium. 20 cases had cardiac tamponade and 14 cases had pericardial tear.

Conclusion: Blunt chest injuries is the predominant cause of death. The involvement of chest injury alone or in combination with other system is present in majority of cases of road traffic accidents.