Over 90% of injuries and deaths still occur in low and middle-income countries like Tanzania due to Road traffic accidents. Available literature indicates that Tanzania suffers massive human and economic losses every year from RTAs despite several interventions that have been made to curb this scourge. To gain an insight into the current state of RTAs we examined the pre- historical case fatality rates from RTAs in Ilala and two other municipalities (Kinondoni and Temeke)inDar es Salaam Region, Tanzania. We conducted a retrospective study using the secondary data on road accidents from Road Accident Information System (RAIS) for the period 2014 to 2018. A total of 6,772 road traffic injuries were reported between 2014 and 2018 and the study recorded the highest RTAs in the year 2014 as compared to the other years within the study period. The death rate from RTAs in Ilala Municipality alone was 36.4 per 100,000 population. About 28% of the total fatalities were recorded among the pedestrians, and there was a significant difference (P < 0.05) in the RTAs among the other road users. The study recommends the improvement of road transport infrastructure to ensure safety for all the road