The objective of our study was to examine cases of musculoskeletal trauma sustained by survivors of a major road traffic accident (RTA), and evaluate their immediate management. Eighty-four RTA survivors were admitted on a single day at the Asir Central Hospital, Abha, Saudi Arabia. The Division of Orthopedics and Traumatology made an assessment of the various musculoskeletal injuries sustained by the survivors, using the Injury Severity Score (ISS) in the evaluation of their condition. Although RTAs are common in Saudi Arabia, there has been no report about one involving the mass transportation service. Of the 84 patients admitted, 41 (48.8%) had an ISS of over 16, indicating major trauma. Twenty-two of these stayed in the hospital for more than three weeks with a mean ISS of 26.36. Musculoskeletal trauma topped the list, and with neurological injuries were found to be a major contributing factor for long hospital stay. Our paper describes the primary management of the musculoskeletal injuries and suggests measures to prevent morbidity relating to these injuries.