Objective To analyze the incidence trend of road traffic accident death in China from 2005 to 2021, and provide reference for reducing road traffic accidents in China.

Methods The incidence data of road traffic accident death in China from 2005 to 2021 were collected. Statistical software Joinpoint 5.0.1.0 was used to fit the trend of standardized mortality of road traffic accidents in China, and the annual percentage change (APC) and average annual percentage change (AAPC) were calculated.

Results From 2005 to 2021, the overall incidence of road traffic accident showed decrease from 16.46/100 000 in 2005 to 11.07/100 000 in 2021 in China (AAPC=−1.70, P=0.004), with an upward trend from 2005 to 2011 (APC=5.80, P<0.001) and a downward trend from 2011 to 2021 (APC=−5.94, P<0.001). From 2005 to 2021, the standardized mortality rate of road traffic accident in men（23.91/100 000） was higher than that in women (7.81/100 000), and the standardized mortality rate of road traffic accidents in both men and women began to decrease in 2011. From 2005 to 2021, the standardized mortality rate of road traffic accident in rural area (18.32/100 000) was higher than that in urban area (11.16/100 000). The standardized mortality rate of road traffic accident began to decrease in 2014 in urban area and in 2011 in rural area. From 2005 to 2021, the road traffic accidents deaths mainly occurred in the age group 15−64 years, and the standardized mortality rate of road traffic accident began to decrease in all age groups in 2011 except age group 0 year. From 2009 to 2021, the standardized mortality rate of road traffic accident in western China (18.24/100 000) was higher than that in eastern China (14.62/100 000) and central China (16.40/100 000). The standardized mortality rates of road traffic accident all showed first increasing then decreasing trends in eastern, central and western China.

Conclusion The standardized mortality rate of road traffic accident showed a downward trend in China, indicating the achievement in the prevention of road traffic injury in China in recent years. However, it is still necessary to pay attention to the prevention and control of road traffic accident in men, people living in rural area, young and middle-aged people and in western China.