The study objective is to identify the most common fatal injuries in car accidents and observe the trends of the proportion of deaths at the scene, in an ambulance, and a hospital. We analyzed all forensic examination reports (protocols) of those who died in the car due to a traffic accident in Moscow from 2018 to 2020. Male drivers died 15 times more often than female drivers, and male passengers died twice as often as females. Most of the victims were young and middle-aged. Both drivers and passengers most commonly had traumatic brain injury with fractures of the bones of the vault and base of the skull, intracranial hemorrhages, crushing, and dislocation of the damaged brain. At the scene of traffic accidents, the cause of death was fatal bodily injuries. An increased risk of fatal traffic accidents was identified in autumn and winter.