OBJECTIVES: to examine the cost-benefit of management strategies for reducing road traffic injuries.  METHODS: The study was a cross-sectional analysis of secondary data retrieved from the Injury Surveillance (IS) in the fiscal year 2004 to 2006.  The sample consisted of all traffic accidental patients who received hospital emergency services.  The two dependent variables used were direct medical cost and death, multiple linear regression models and binary logistic regression models were constructed.  The outputs of management strategies: non-use of crash helmets and drunk driving were explained by using Monte Carlo technique.  RESULTS: The study covered 12,651 patients.  For the regression analysis, statistically significant predictors were composed of sex, age, drunk driving, non-use of crash helmets, accidental timing, victim and severity (adjusted R2=0.60).  For the binary logistic regression analysis, odd-ratio of the causes of death of non-use of safety equipments (helmet and seatbelt) and drunk driving were 3.56 (CI 2.62-4.85) and 1.24 (CI 1.01-1.53) respectively.  The direct medical cost arrived at from using the regression model when using law enforcement with 50 percent succession of both strategies was THB20,983,413.59.  Compare with the current situation, it was THB26,709,449.76 (21.44% save).  In the same way, the net benefit gain from these enforcement was THB512,894,977.48. (58.44% save).  Nevertheless, changing each assumption of the successful management strategies from 10% to 50%, the sensitivity analysis shows the range of saving from 24.67% to 58.44% and the benefit to cost ratio was 10.81. CONCLUSIONS: These findings show the scenario to reduce traffic injury, the law enforcement strategies for using safety equipment and reduce the number drunk driving is a useful management tool to reduce cost of illness nearly three-quarters of the damages from road traffic injuries.