The objective of this retrospective study was to describe demographic characteristics, injury patterns and causes of road traffic crashes (RTCs) managed by Rescue 1122 in Lahore, Pakistan during the period 2005–2010. In total 123,268 RTCs were reported and responded by Rescue 1122 ambulance service during the study period. Of the 132,504 victims of RTCs, there were 67% male and 33% female subjects, and the maximum share (65%) was reported among people aged 16–35 years. Motorcyclists were involved in 45% of crashes, with over-speeding (40%) found to be the major reason of these collisions. Similarly, minor injuries (65%) and fractures (25%) were the most reported outcome of these crashes. It is concluded that data from ambulance services, if appropriately collected, can provide valuable epidemiological information to monitor RTCs in developing countries. However, in Pakistan, the collection of data as well as the registration process needs further improvement.