In Saudi Arabia, road traffic crashes are becoming a serious public health problem and there are no recent, large-scale, published reports discussing maternal and fetal injuries. We aimed to explore the predictors of fetal death/abortion after maternal trauma. A retrospective case-control study was performed exploring cases of maternal trauma. The study group included 118 women with pregnancy loss while 308 women without loss represented the control group. All data were compared using univariate analysis followed by multivariate regression analysis. Only 3 predictors were associated with significant effect on pregnancy loss after trauma (P < 0.05): second trimester of pregnancy (OR 2.77, 95% CI: 1.66-4.63, placental abruption (OR 3.69, 95% CI 2.01-6.79) and severe injury score (OR 6.78, 95% CI: 4.04-11.37).