In 2010, Member States at the United Nations General Assembly unanimously adopted a Resolution proclaiming a Decade of Action for Road Safety (2011 - 2020). The extent of support for this resolution by Member States indicates a growing awareness of the scale and devastation of road traffic injuries as a global public health and development concern. This report, which establishes the baseline burden of road traffic crashes and the status of global road safety efforts at the start of the Decade of Action, shows that 1.26 million people were killed on the world's roads in 2010. This is unacceptably high. Road traffic injuries take an enormous toll on individuals and communities as well as on national economies. Middle-income countries, which are motorizing rapidly, are the hardest hit. In addition to providing a baseline, this report also illustrates some of the progress made in a number of countries to reduce road traffic deaths over the past three years, since publication of the first global status report on road safety in 2009. This progress has occurred by translating strong political will into a series of coordinated actions at the national and local levels. Indeed, stabilizing the global number of road traffic deaths over the past three years in the face of rapid motorization suggest that the measures put into place are having an impact--albeit slowly--and are preventing further rises in road traffic deaths.