A 21-year (1980-2000) retrospective review of 84 pregnant women involved in road traffic accidents in Southwest Nigeria was conducted. Case notes of these 84 pregnant women treated at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, were studied. Pregnant women formed 0.3% of all individuals involved in accidents during the study period compared to 7% reported in developed countries. The fetal death rate of 3.6% and maternal death rate of 2.4% in this study were lower than the fetal death rates of 57% and maternal death rate of 8-16% reported in developed countries. There was no obvious injury in 23.8%, while in 76.2% there were serious maternal injuries ranging from limb fractures, pelvic bone fracture, quadriplegia, uterine rupture, abruption placenta, lacerations, etc. Fetal tachycardia was observed in 11.9%. Despite these injuries, the majority (80.9%) achieved spontaneous vaginal deliveries; 16.7% were lost to follow-up, while 2.4% had an emergency caesarean section for reasons unrelated to the accidents. Preventive measures such as proper screening of drivers before issuing driving licences, separation of vehicular and pedestrian traffic, installation and enforcement of the use of seat belts, restrictions of alcohol ingestion while driving, use of a crash helmet by cyclists would drastically reduce the incidence of these accidents.