Introduction: Hands are very important for daily living with varied functions being carried out from simple to complex. Any trauma which affects the composite tissues of hand may significantly affect the function depending upon the severity of injury. Road traffic accidents are one of the cause of trauma to hand and this study aimed to know the epidemiological patterns of metacarpal and phalangeal fractures in Road Traffic Accidents (R.T.A) and the pattern of surgical procedures done in metacarpal and phalangeal fractures. Material and Methods: This was a retrospective record analysis of 37 cases of metacarpal and phalangeal fractures conducted by Dept of Plastic Surgery at St John's medical college hospital, Bangalore. Records of R.T.A presenting with metacarpal and phalangeal fractures irrespective of age and sex were analysed. The records of pure soft tissue injuries of hand, wrist bones and burns were excluded. Data were analyzed and projected in the form of tables and figures. Results: 37 patients had R.T.A, with a male preponderence of 89% and the mean age was 28 yrs. Right hand bone involvement were seen in 43% with most injuries being open (70%) and multiple fingers with little finger were affected in equal proportions (24%). Predominant surgical procedures done were bony stabilization in 35%, followed by tacking sutures in 27% of pts. Conclusion: The pattern recorded were young males with multiple compound bone fractures with a predominance of little finger involvement.