Introduction: The urban road traffic accident (RTA) risks for the city of Zagreb, Croatia, from 1999 through 2000 were analyzed with the aim of reducing the increasing injury incidence. Method: Simple and bivariate analysis using χ 2, odds ratio, and confidence interval of 95% was used to determine risks in three outcome groups: killed, severely, and mildly injured. Results: There were 528 RTA victims consisting of 260 severely, 213 mildly injured, and 55 killed at the scene of an accident and during transportation. More fatal accidents occurred during night hours (OR = 3.78; 95% CI, 2.08–6.85), on urban road links (OR = 2.33; 95% CI, 1.30–4.19), and at exceeding speed limit (OR = 2.56; 95% CI, 1.43–4.61). More people were injured than killed on urban junctions (OR = 5.27; 95% CI, 2.21–12.57). The highest combined risk of dying or being severely injured was found in males, driving at excessive speed, on urban links, and during bad visibility (OR = 16.15; 95% CI, 3.901–66.881). Conclusion: These results will influence the urban traffic police enforcement measures, which will change inappropriate behavior of drivers and protect the least experienced road users.