Trauma is defined as any harm occurs to the human body due to application of force. Every minute in life we are liable to different forms of trauma. Traumatic injuries are one of the leading causes for death and infirmities. There is increasing rate of exposure to trauma especially in developing countries. This raises the concern for documentation and analysis of the causes to plan preventive strategy to decrease the mortality and morbidity. Aim of the study: to cast light on the pattern of trauma and mortality causes, patients at risk and the value of documentation in medicolegal work and in helping the authorities identifying the changes in causes of trauma pattern helping in building preventive measures Subjects and methods: Descriptive retrograde study done on patients admitted to tertiary trauma center in Assiut University Hospitals (AUH) in the period from 2005- 2012. Analysis of the demographic data, cause and site of injury and mortality cases were carried out. Results: 77,380 patients were admitted during the period of the study. Age mean± SD was 29.41± 20.8 years, males were more predominant 75.5% compared to 24.5% females. The improvement was 78.9% in admitted patients and the death rate was 4%. The top causes of injury and mortality were; falling on the ground, road traffic accidents, falling from height, interpersonal violence and blunt injuries. The most affected body site was the lower limbs, upper limbs, head, vertebral column, chest, pelvis followed by abdomen. Conclusion: the road traffic accidents, falling accidents and interpersonal violence were the main causes of mortality. Attention must be paid for the young patients exposed to these injuries especially if head, lower limb, chest or abdomen were affected as they were at increasing risk. Also, Attention must be paid for documentation of injuries in details due to its medicolegal value.