Background: - Road traffic accidents are one of the main public health problem results pre-maturerndeath and injuries in the world. Ethiopia is among the leading countries in road traffic accident in thernworld. Addis Ababa â€“ Adama Expressway is one of the newly introduced modern toll road with arntraffic accident are occurred increasingly. This study describes prevalence, trend and associated factorrnof road traffic injury crashes. rnObjectives: To assess the prevalence and trend of road traffic injury crash and associated factors onrnAddis Ababa-Adama Expressway. rnMethods: - The study is based on the secondary data collected from Ethiopian Toll Road Enterprisesrnfrom September 2014 to August 2018. The collected data contained information about the cause ofrnaccident, types of accidents, human causality and injury and other relevant information on thernenvironmental condition and vehicle characteristics. Electronic data received in excel sheet wasrntransferred to SPSS statistical software for analysis. Bivariate and multivariate Logistic regressionrnanalysis was employed to determine the possible predictors.rn.rnResults: - The overall prevalence of RTIC was (30%). In bivariate logistic regression: age of driver,rnseason, types of vehicle, and types of collision and cause of road traffic crashes were significantrnassociation with RTC. Socio-demographic status, being 50 and above(AOR=2.03, 95% CI: 1.13, 2.58),rntypes of vehicle status, being minibus and bus (AOR- 2.75, 95% CI: 1.88, 4.02), pick up and mediumrntruck (AOR= 1.88, 95% CI: 1.30, 2.71), automobile( AOR= 1.50, 95% CI: 1.07,2.10), car overthrowrn(AOR= 2.00, 95% CI: 1.49, 2.67), sleeping/fatigue (AOR= 2.76, 95% CI: 1.15, 4.62), over speedingrn(AOR= 1.53, 95% CI: 1.10, 1.12) and unethical driving (AOR= 1.43 95% CI: 1.08, 1.90). rnConclusion: Road traffic injury crash on Addis Ababa-Adama Expressway become increasing. Thisrntrend showed that the issue need urgent attention and consider as a priority public health agenda.