Road traffic injuries (RTIs) are a

Road traffic injuries (RTIs) are a significant public health challenge and projected to be the fifth leading contributor to the global burden of disease by 2030 [1]. Over 90% of fatal crashes occur in low and middle-income countries with substantial consequences, particularly for vulnerable road users such as pedestrians, cyclists, and riders of motorised two-wheelers [2-4]. In Pacific Island countries and territories, the published literature suggests that RTIs and their attendant risks are a significant but poorly quantified cause of death and disability [5-7]. It has been reported that up to half of all fatal injuries in the Pacific are due to road traffic crashes [8]. Previous commentators and researchers have also drawn attention to the impact of RTIs among Pacific populations, highlighting factors that require particular attention such as alcohol, motorisation, poor driving, seatbelt use, and poorly maintained vehicles and roads [9-15]. The Global road safety survey identifies Pacific Island countryspecific characteristics from the perspectives of government statistics and stakeholders [16]. However in order to develop effective road safety initiatives that are relevant for the Pacific context, it is important to assess the quality of local research evidence examining the burden and risk factors for road crashes, and gain a broader appreciation of its utility to influence national policy and behavioural change [17-19]. To this end, we undertook a systematic review of the published literature of epidemiological studies investigating the burden of and modifiable risk factors for RTIs in less resourced Pacific countries.