A better understanding of trauma epidemiology may allow to enhance the organisation of trauma systems with a potentially relevant impact on the level of trauma care. A one year epidemiology study (1st March 1998-28th February 1999) was planned in Friuli Venezia Giulia with the aim to collect all prehospital, hospital and outcome data of patients who sustained a major trauma (ISS > 15) within the regional border. In 12 months 15,429 traumatized patients (14,108 residents) were admitted to any one of the Regional hospitals. Over 1% of the whole population sustained injuries severe enough to cause hospital admission. 630 people (77.3% male, 27.7% female average age 42 ys) had a major trauma. The incidence of major trauma is 525 per million people per year. RTA was by far the most important cause of major injuries (78.6%) followed by work accidents (6.8%), domestic (5.9%) and sport accidents (1.9%). Only 1.2% of all the major injuries was the consequence of interpersonal violence. One hundred-sixty-six trauma victims died on the spot (149) or before hospital arrival (17). 464 patients with major injuries reached the hospital alive. More than two third of the patients with ISS > 15, suffered from a multiple trauma. 70% had a severe injury to the head (AIS > or = 3). Head trauma occurred as an isolated injury in only 35.3%. Hospital mortality within 30 days from admission (trauma death) was 25.1%. The results of the follow-up at 6 months are still incomplete. However the preliminary data clearly show that a high percentage of the patients who were discharged alive from the ICU had a good neurologic recovery.