In recent years a vigorous effort has been made to improve primary trauma care in Israel. The Ministry of Health and other authorities have invested in new facilities in various hospitals which are engaged in trauma care. A survey was conducted in order to identify deficiencies in organization, personnel and equipment required to provide optimal trauma care. A cross-country survey was conducted by using a questionnaire that dealt with structure and process components of trauma care. The questionnaire was submitted to medical directors of emergency departments in all 24 acute-care hospitals in Israel. Additional information was obtained by a telephone poll when required. Inter-hospital variation concerning structure of trauma services, protocols and qualification of manpower responsible for primary care of the injured was found. The conclusions are that an increase in homogeneity in the field of trauma care is still needed. A continuous effort should be made in order to structurally and functionally further develop independent trauma units in all hospitals in Israel. Methods should be found to encourage young physicians to enter the field of trauma care. The establishment of a nationwide trauma registry system will undoubtedly contribute to future improvement in the initial care of the injured in Israel.