The Arab Gulf States have undergone a rapid emergence from a rural society into modern urbanisation in a relatively short period of time. In the past century, the world's hunger for petroleum products has accelerated the interaction with Arabian society and brought new dangers, the most striking being the introduction of the automobile. According to World Health Organization statistics, the death rate on the roads is approximately four-fold greater in the Gulf States than in Europe or America and the financial cost is in the billions of dollars. Care of the injured patient in the Arab Gulf States has a special significance for the population, particularly because of the high incidence of motor vehicle-related trauma. While efforts are being directed towards primary prevention and, in many ways, the greatest gain from morbidity and mortality can be achieved here, there is a need to craft a system that minimises the outcome of the injury when it does occur. Not only does this require system organisation, but also it is essential that the expertise gained abroad by surgeons training in trauma and critical care be incorporated into the system.