Road traffic accidents (RTA) have been the bane of the modern civilization accounting for considerable loss to the nation. Head injuries are leading causes of death from vehicle crashes with many deaths occurring despite optimal use of the available treatment facilities. Hence the present study was conducted to know the patterns of head injuries in fatal accidents involving vehicles. This study was conducted from 1st sept 2013 to 1st sept 2014 at MGM Hospital attached Mortuary, Aurangabad. The present study entirely focuses on the patterns of head injuries in fatal accidents who were autopsied during this period. A total of 100 cases of deaths due to vehicular accidents were reported for the autopsy. Most victims were male (89%). The age span of 20–60 years comprises 83% of all road traffic accident deaths. The deaths in road traffic accidents were more among married persons, (64%). It was observed that majority of victims involved in road traffic accident 23 cases (62%) were addicted to alcohol. It was observed that incidents leading to maximum number of deaths occurred during 06 PM to 9 PM and 06 AM to 9 AM. Abrasion + contusion +laceration+ crush was the most common combination of injuries sustained by the victims observed in 37cases (37%), Fissured fracture Was commonest pattern of fracture observed in 58% in these accidents. Extradural and subdural hemorrhage was the most common and present in 27 (24.57%) cases.