Road safety in Kathmandu Valley and Nepal remains a critical concern, with persistent challenges despite ongoing efforts to mitigate traffic accidents. This study examines registered crashes, fatalities, injuries, contributing factors, and demographic-specific data from 2015 to 2024, highlighting key trends and areas requiring intervention. The data reveals a consistent rise in crashes across Nepal, peaking at 24,537 in 2023, with Kathmandu Valley contributing significantly, particularly during 2020 when it accounted for 64.5% of national crashes. Fatalities show a declining trend nationally and, in the valley, with 2024 recording the lowest figures, though pedestrian-related accidents and those involving two-wheelers remain the most fatal. Injuries from road accidents demonstrate a similar pattern, with minor injuries notably increasing before a decline in 2024, reflecting the frequency of less severe accidents. Behavioral factors, such as driver negligence and over speeding, are the leading contributors to crashes, accounting for the majority of incidents in both Nepal and Kathmandu Valley. Demographic analysis indicates that males, young adults, and motorcycle users are particularly vulnerable, emphasizing the need for targeted safety measures for these high-risk groups. The findings underscore the importance of implementing comprehensive road safety strategies, including stricter enforcement of traffic laws, infrastructure improvements, and awareness campaigns addressing driver behavior. Enhanced data collection and analysis can further support evidence-based policymaking to reduce crashes, fatalities, and injuries across Nepal, particularly in urban centers like Kathmandu Valley.