Globally, road traffic accidents are an important public health concern which needs to be tackled. A multidisciplinary approach is required to understand what causes them and to provide the evidence for policy support. In Spain, one of the roads with the highest fatality rate is the crosstown road, a particular type of rural road in which urban and interurban traffic meet, producing conflicts and interference with the population. This paper contributes to the previous existing research on the Spanish crosstown roads, providing a new vision that had not been analyzed so far: the driver’s perspective. The main purpose of the investigation is to identify the contributing factors that increment the likelihood of a fatal outcome based on single-vehicle crashes, which occurred on Spanish crosstown roads in the period 2006-2016. In order to achieve this aim, 1064 accidents have been analyzed, applying a latent cluster analysis as an initial tool for the fragmentation of crashes. Next, a multinomial logit (MNL) model was applied to find the most important factors involved in driver injury severity. The statistical analysis reveals that factors such as lateral crosstown roads, low traffic volumes, higher percentages of heavy vehicles, wider lanes, the non-existence of road markings, and finally, infractions, increase the severity of the drivers’ injuries.