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Objective: Road crashes are considered as the eighth leading causes of death. There is a wide disparity in crash severity and law enforcement efficiency among low-, medium-, and high-income countries. It would be helpful to review the crash severity trends in these countries, identify the vulnerable road users, and understand the law enforcement effectiveness in devising efficient road safety improvement strategies.Method: The crash severity, fatality rate among various age groups, and law enforcement strategies of 10 countries representing low-income (i.e., India and Morocco), medium-income (i.e. Argentina, South Korea, and Greece), and high-income (i.e., Australia, Canada, France, the UK, and the United States) are studied and compared for a period of 5 years (i.e., 2008 to 2012). The critical parameters affecting road safety are identified and correlated with education, culture, and basic compliance with traffic safety laws. In the process, possible road safety improvement strategies are identified for low-income countries.Results: The number of registered vehicles shows an increasing trend for low-income countries as do the crash rate and crash severity. Compliance related to seat belt and helmet laws is high in high-income countries. In addition, recent seat belt- and helmet-related safety programs in middle-income countries helped to curb fatalities. Noncompliance with safety laws in low-income countries is attributed to education, culture, and inefficient law enforcement.Conclusion: Efficient law enforcement and effective safety education taking into account cultural diversity are the key aspects to reduce traffic-related injuries and fatalities in low-income countries like India. [ABSTRACT FROM AUTHOR]