Clinical data on the nature and severity of injuries was linked with data from police crash reports for 3675 car or truck drivers admitted to trauma centers. Different patterns of injuries were noted for drivers in frontal compared with left lateral collisions. Injuries to the face and lower extremities were significantly greater in frontal collisions; thorax, abdominal, and pelvic injuries were significantly greater in lateral collisions. In addition, drivers in lateral collisions were found to have significantly more multiple injuries to the abdomen and thorax. Despite no difference in mean injury Severity Score, drivers in left lateral collisions had a significantly higher mortality rate; moreover, this increased mortality was not merely a reflection of the increased incidence of lateral collisions among older drivers. In conclusion, information on direction of impact has potential use for clinical decision making, since drivers in lateral collisions have a higher incidence of occult abdominal and thoracic injuries.