Background: Kenya has a soaring rate of road traffic fatalities. Available evidence suggests significant alcohol-relatedness to trauma. We know little about the prevalence of alcohol-related injuries in Nairobi. Objective: To determine the extent and pattern of alcohol use in subjects admitted following road traffic accident. Design: A descriptive hospital based survey. Setting: Kenyatta National Hospital (KNH)- a university affiliated hospital in Nairobi, Kenya. Results: The overall incidence of alcohol use was 26.3%. This was higher in males (29.6%) than females (9.1%). Use was 24.4%, 31.0%, 28.6% and 13.6% in the 16-25, 26-35, 36-45 and 46-55 age groups respectively. The mean ages, pre-hospital times and ISS were similar for the AUG and NAUG. The incidence of males, weekend injuries, night collisions, and pedestrian involvement was 94.4%, 69.4%, 41.7%, 77.8% in the AUG and 83.2%, 35.6%, 19.8% and 61.4% in the NAUG respectively. The incidence of head and extremity injuries in AUG was 27.8% and 50% respectively compared to 11.9% and 66.3% in the NAUG. Treatment costs were higher for the NAUG. Conclusions: The results suggest a high incidence and potential alcohol-relatedness to road trauma in Nairobi. The study calls for objective evaluation of the extent, interactions and effects of this modifiable trauma factor.