Summary: Horses involved in road traffic accidents (RTAs) are commonly presented to veterinarians with varying types of injuries. The aim of this study was describe the pattern and severity of traffic accident-related injuries in horses in a single hospital population. Medical records of horses either hit by a motorized vehicle or involved in RTAs whilst being transported from 1993 to 2015 were retrospectively reviewed and the following data was extracted: Signalement, hospitalisation time, month in which the accident happened, cause of the accident, place of the accident and type of vehicle hitting the horse. Further the different body sites injured (head, neck, breast, fore limb, abdomen, back and spine, pelvis and ileosacral region, hind limb, tail and genital region), the type of injury (wounds, musculoskeletal lesions and internal lesions) and the presence of neurological signs were retrieved from the medical records. 34 horses hit by motorized vehicles and 13 horses involved in RTAs whilst being transported were included in the study. Most of the accidents where horses were hit by motorized vehicles occurred during December (14.7 %) and October (14.7 %), horses were most commonly hit by cars (85.3 %) and the majority of accidents occurred on main roads (26.5 %). In 29.4 % of the cases, horses had escaped from their paddock and then collided with a motorized vehicle. Most of the accidents with horses involved in RTAs whilst being transported occurred during April (30.8 %) and June (23.1%). In 76.9 % of the cases the accident happened on a freeway. In the horses hit by motorized vehicles the proximal hind limbs were the body site most commonly affected (44.1%), followed by the proximal front limbs (38.2 %) and the head (32.4 %). When horses were involved in RTAs whilst being transported the proximal fore limbs (61.5 %), the proximal hind limbs (53.8 %) and the distal hind limbs, back and head (38.5 % each) were the most common injured body sites. Wounds were the most common type of injury in both groups (85.3 % hit by motorized vehicle, 76.9 % transported ones). In horses hit by a motorized vehicle 35.3 % suffered from fractures, in 20.6 % a synovial structure was involved and in 5.9 % a tendon lesion was present. 14.7 % suffered from internal lesions and 14.7 % showed neurologic symptoms (40 % peripheral, 60 % central neurologic deficits). On the other hand, in horses involved in a RTA whilst being transported 30.8 % suffered from fractures. There were no synovial structures injured and no tendon injuries were present. Furthermore there were no internal lesions present and only one horse involved in a RTA showed central neurologic symptoms. Injuries of horses being hit by a motorized vehicle were more severe than when horses were protected by a trailer and involved in a RTA whilst being transported. The study has been able to identify the different injury types of traffic accident-related injuries in horses. Awareness of the nature of these injuries is important, to avoid underestimation of their severity.