Objectives: This study aimed to provide information on the epidemiology, trend, associated traumatic spinal cord injury (TSCI) and non-spinal injuries, and risk factors affecting the in-hospital outcome of RTA-related traumatic spinal injury (TSI) over the past decade in Aseer province, Saudi Arabia. Methods: In this retrospective study, we included all RTA-related traumatic injuries (5797) admitted to ACH from 1st January 2010 to 31 December 2019, from which 810 cases were TSIs. The cases were identified through the hospital database registry.. Descriptive analysis was performed for gender, age, level of spinal injury, admission day, type of care unit, associated injuries, presence of TSCI and discharge category. Results: TSIs accounted for 13.97% of RTA-related injuries with a predominantly male population. The patients had a mean age of 30.7 years, 46.67 % of victims were between 19 to 30-years old. There was a significant decrease in the number of RTA-related TSIs over the study period. Lumbar and cervical injuries were more prevalent (32.47 and 31.36 %, respectively). Most (73.58 %) TSIs occurred during working days, and 6.54% required critical care admission. Associated non-spinal injuries occurred in 50.25% and TSCI in 6.91% of patients. The in-hospital mortality was 5.18%. The Age, level of spine injury, need for critical care, associated injuries, and TSCI significantly affected the likelihood of improvement. Conclusion: The latest government initiatives to reduce RTA like speed limits and waring of seat belts have resulted in a concordant decline in TSI incidence with good consistency between police and health registration data doi: https://doi.org/10.12669/pjms.38.3.5288 How to cite this:Algahtany MA. Epidemiology, trend and in-hospital outcome of traumatic spinal injuries due to road traffic accidents. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5288 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.