Road traffic accidents (RTAs) are a major cause of death and injury globally. There was little information on the burden and causes of RTAs in Bhutan. The study estimates the burden and characteristics of RTAs and describes the victims of RTAs in Bhutan. A descriptive cross-sectional study conducted analysing police case records. In 2013-2014, 1866 accidents resulted in 1143 injuries and 157 deaths. We identified 39% more deaths from RTAs than that submitted to WHO in 2013 as the 30-day mortality. The main causes were careless driving and drunk-driving. Drivers and passengers constituted 86% of the deaths with few pedestrian deaths. Data for in-hospital deaths or after discharge were not available. Productivity loss due to RTA is around 1% of national GDP. There is significant mortality and morbidity from RTAs in Bhutan. There is no coordinated system for data collection and surveillance to monitor SDG goal 3.6.

Introduction and Aims Bhutan has a high incidence of alcohol‐related disease. With economic development, motorised transport is proliferating, increasing the potential for traffic injury. We investigated drink‐driving in the country's largest urban environment. Methods Working with police, we set up checkpoints at major thoroughfares in Thimphu, on Tuesday, Friday and Saturday nights, from May to July 2017. Police directed cars to testing bays where drivers were breathalysed and interviewed. Results All 1596 drivers stopped by police were breathalysed, and 212 (13%) tested positive. Blood alcohol of >0.02 g/dL (which we defined as ‘probable impairment’) was detected in 178 drivers (11%), while 67 (4.2%) exceeded the legal limit of 0.08 g/dL. Probable impairment was more common in men, older drivers, on Tuesdays (versus Fridays or Saturdays) and later at night. Conclusion Drink‐driving is very common at night‐time in Bhutan. Routine roadside random breath‐testing, and media campaigns emphasising the risk of apprehension and consequent serious financial and social penalties, should be considered to deter drink‐driving.