With the support and cooperation of the Kanchipuram district police and Tamil Nadu police, researchers conducted detailed investigations of accidents occurring on the National Highway 45 over a 60 km stretch. The primary objective was to collect and analyze India-based traffic crash data to begin to create a sound basis for decision making for improving safety on India's roadways. A secondary objective was to establish a standardized methodology using economical tools for collecting and analyzing crash data, specific to Indian roads. For the 45 day study period, an accident intimation network was established between researchers and all police stations/highway patrols in the study area. On occurrence of an accident, police called a 24-hour contact number and researchers responded to the scene. On site, researchers used standardized reporting forms, methodologies, and equipment to perform accident scene examinations, accident vehicle examination, and AIS injury coding. The collected accident data was categorized first by single- or multiple-vehicle crash and next by accident type based on the first accident event. The data was then analyzed to identify accident (crash type, location time), vehicle (vehicle type, pre-crash condition), occupant (restraint use, gender, age) and other contributing factors, and environmental factors associated with injury severity. Findings show that front-to-rear collisions, mainly involving trucks and buses, caused due to slowing down, stopping, breaking down or overtaking account for 58% of the accidents. This paper presents the methodology adopted, data analysis, results, conclusions and recommendations to mitigate road accidents and injuries on NH 45 and other similar highways.