Background: In India, 1.77 lakh people died in traffic accidents in 2015. Thoracic cage houses body’s most important organs for breathing and circulation. Any damage to it has a significant negative impact on one’s chances of living. Objective of this study is to examine pattern of abdominal and thoracic injuries in fatal motor vehicle accident cases. Study design: Autopsy cases of road traffic accidents sustaining thoraco abdominal injuries which are brought to mortuary of Belagavi Institute of Medical Sciences Civil Hospital and KLE’s Dr. Prabhakar Kore Hospital. Sample size: 105. Results: 82% victims were males and 52% were among age range of 21-40 years. Commonest cause for death was hemorrhagic shock in 51 cases (48.57%) and most common period of survival was within 2 hours of occurrence of accident in 30 victims (28.57%). The commonest organ to be involved was lungs in 67 (63.8%) cases and second most common organ and commonest abdominal organ to be involved was spleen in 55 (52.38%) cases, 3rd commonest organ and 2nd commonest abdominal organ to be involved was liver in 50 ( 47.6%) cases. The commonest injury seen was rib fracture in 60% cases and hemoperitoneum was commonest abdominal injury found in 49 (46.66%) cases followed by liver laceration in 31 cases (29.52%).  Conclusion: Non Government Organizations, police and also individuals who witness any accident should provide prehospital care to injured patients which will reduce fatality to a large extent. Ambulances should not be just transport vehicles but they should be well equipped with pre hospital treatment facilities.