The trauma pyramid offers a useful concept. The small number of fatalities are at the tip; injuries presenting to family physicians, community clinics, and hospitals occupy the center; and the large number of unreported injuries are at the base. Most countries have well-established systems for reporting aggregate mortality data from death certificates. Hospital records are the usual sources of injury morbidity data, although the data have major limitations. However, the data clearly reveal that trauma has major importance to public health. The main causes of injury are traffic accidents, accidents in the home, and accidents during leisure or athletic activities. Trauma imposes enormous direct costs on the community as well as direct and indirect effects on the quality of life of victims and their families. Implementing effective primary, secondary, and tertiary injury prevention programs involves major organizational, technical, and financial barriers due to ignorance, ineffectiveness, and indifference. A model national trauma prevention strategy would consist of a stated goal, specific objectives listed in order of priority, a series of programs, performance targets for each program, and anticipated resource requirements over defined time periods. No single agency in the United Kingdom has responsibility for injury prevention. An integrated public health effort is needed. Recommendations, chart, and 30 references