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Compared to a decade ago, the number of vehicles registered in Nepal has increased threefold from approximately 300,000 to 1.34 million, and along with it, a fourfold increase in road crashes and fatalities.In 2001, there were less than 4000 crashes, which have jumped close to 9,000 in 2012.Data shows four to five people die every day due to road crashes.While adults constitute the largest number of deaths, 13 percent of total fatalities include children (under the age of 16).Government data also shows every seven crashes resulted in a fatality.In certain parts of the country, the ratio of crashes and fatality could be as high as one to one.This paper describes the current state of road safety in Nepal, characterizes road crashes, and discusses contributing factors.It also describes implementation activities undertaken by concerned stakeholders to reduce crashes.Finally, it provides specific recommendations that can assist stakeholders to implement programs and intervention measures relatively quickly to improve overall road safety.The road safety "crisis" in Nepal is not unique.The majority of underdeveloped and developing countries in Africa and South Asia has experienced surges in road crashes and are scrambling to find solutions.The paper will resonate well with audiences from countries in South Asian and African continent and help create common understanding of specific problems and find solutions to improve road safety in those regions.