Background: Road traffic accidents remains as one of the leading causes of death and life-long disability worldwide. Objectives: This study aimed to determine the prevalence and associated risk factors for road traffic accidents in Juba, South Sudan. Methods and materials: This are a retrospective study using data from registers at Juba Teaching Hospital and Directorate of Traffic police between 1st January to 31st December 2018. Data were collected, cleaned and entered into a computer database. Statistical analysis was performed using SPSS Version 21 Software. A variable with a p value of <0.05 was considered statistically significant. Results: Out of 7862 patients were recorded in the OPD at Juba Teaching Hospital (JTH), 7.3 % (575/7862) were road traffic accident (RTA) cases. This is at rate of 7313 per 100,000 of the population. Of all the 575 cases of RTA in JTH, 82% (472/575) were males and 18% (103/575) females with age ranging from 9 months to 97yrs and a mean age of 26.9yrs, SD+/-12.53. Most of the patients 37 % (214/575) were of age group 31-40years, with majority 36% (207/575) coming from an unidentified location. Munuki block had the highest 25.2% (145/575) within Juba city council , while areas outside Juba city council had the least 7.5% (43/575). Interestingly most of the patients 44 % (253/575) presented to the OPD at night, while 19 % (111/575) presented in the morning. Most 20 % (113/575) presented to the OPD in May 4 % (23/575). There were no cases in June.Out of 1081 drivers involved in RTA, age group 31-40yrs (37%), 21-30yrs (37%), 21-30yrs (36%), 31-40yrs (42%) and 31-40yrs (31%) had an outcome of car accidents causing death, severe injuries, slight injuries, damage and influenced by alcohol respectively with p=0.015. It was noted that 81% (926/1141) drivers had driving licenses, while 19% (215/1141) driving without licenses. Private cars were associated with the highest outcome;56% causing death, 50% causing slight injuries and 42% causing severe injuries with p=0.01. Unfortunately, 82% of drivers driving under alcohol influence were drivers driving private cars as the highest with p=0.000. Out of the 1472 cars registered, majority were private cars 38% (27/71), 36% (134/373), 47% (222/475) and100% (11/11) were involved in accidents causing death, severe injuries, damage to property and driven under influence of alcohol respectively with p=0.003. Motorcycles reminded leading cause of slight injuries, 39 % (214/542) but also the second leading in causing severe injury 35 % (190/542) as well as damage to property 20 % (96/475). Most of the cars 22% (13/58) caused accidents resulting to death as well as slight injuries 16.8% (67/404) in March; severe injuries 13.3% (39/291) seen in November, where as damage to the property 13.6% (40/296) in February. Accidents due alcohol intoxication 50% (16/32) were seen in January but p=0.58. Conclusion: Road traffic accidents still remain a public health problem in Juba with younger age drivers involved in accidents.