Objectives: To compare the crash reporting system of National Highways Motorways Police (NHMP), Pakistan, with the World Health Organization (WHO) injury surveillance guidelines. Methods: Based on information collected from field observations, key informant interviews, and review of official documents, this note firstly describes the reporting system according to the components of a surveillance system. Then the reporting is compared with WHO criteria for designing and building an injury surveillance system and attributes of such a system. Results: After a crash, a patrol officer communicates the information to the higher police authorities by wireless, fax, and on paper in the first 24 hours. Microcomputer Accident Analysis Package (MAAP) Performa filed by the officers are collected at a central location in the following 4 days, and reports are published biannually. Notable deficiencies in the reporting were nonidentification of stakeholders for data utilization and limited prospects of data recording process modification and its monitoring. Moreover, crash and injury definitions do not conform to international standards practiced elsewhere. Conclusion: NHMP crash reporting needs to be simplified and standardized, and steps should be taken to improve its utilization for prevention purposes.