Trauma-care systems in India are at a nascent stage of development. Industrialized cities, rural towns, and villages coexist with a variety of health care facilities and an almost complete lack of organized trauma care. There is gross disparity between trauma services available in various parts of the country. Rural India has inefficient services for trauma care, due to the varied topography, financial constraints, and lack of appropriate health infrastructure. There is no national lead agency to coordinate various components of a trauma system. No mechanism for accreditation of trauma centers and professionals exists. Education in trauma life-support skills has only recently become available. A nationwide survey encompassing various facilities has documented significant deficiencies in current trauma systems. Some initiatives on improving prehospital systems have been seen recently. Although injury is a major public-health problem, the government, medical fraternity, and the society are yet to recognize it as a significant public health challenge.