Two-wheeler trauma in developing countries differs in some respects when compared to that in developed countries. A total of 302 cases involved in motorcycle, scooter, and moped accidents were analyzed. There were 201 drivers and 101 passengers. Injury severity scores (ISS), overall number of wounds, and number of fractures were studied. Motorcycle riders had a significantly higher ISS than did scooter riders. Persons involved in collisions with other powered vehicles had 36% more fractures and higher ISS than those involved in accidents where no collision occurred with a powered vehicle. Female passengers, sitting sideways, and involved in collisions, sustained fewer injuries than did a comparable group of male passengers who sat astride; the ISS of female passengers was also lower. Helmet users had a much lower incidence and severity of head injury than riders who did not use helmets. Turbans appeared to offer partial protection from head injury.