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Objective. This study aimed to identify the areas with the highest concentration of traffic accidents and injuries in the San Salvador Metropolitan Area (SSMA). Materials and methods. Traffic accidents were analyzed spatially by point location and by the sum of events in areas of 200 m2. The point location was analyzed by "nearest neighbor analysis", while the areas with the sum of traffic accidents were analyzed by Getis-Ord Gi* to obtain the hot spots. The resulting hot spots with the highest concentration of traffic accidents in the SSMA were evaluated in the field using an observation form to collect data on infrastructure and road safety characteristics. Results. Five areas with the highest number of traffic accidents and injuries, mainly containing primary roads, were identified by analyzing 8191 traffic accidents reported between 2014-2018. Conclusion. The sites with the highest concentration of traffic accidents and injuries were characterized by considerably damaged road infrastructure and the lack of safety systems for drivers and pedestrians. The spatial analysis of traffic accidents and injuries can contribute to improve surveillance and road safety in the SSMA. [ABSTRACT FROM AUTHOR]