An analysis of data from the New Zealand Major Trauma Registry has shown that continued injury prevention efforts focusing on males, Māori and transport incidents are required. A total of 4186 major trauma incidents among 20-65-year-olds occurred during the period 1 July 2017 to 30 June 2020, of which 5.6% were fatal. The majority of those injured were male (77%). Māori had significantly higher rates of major trauma (79.2 per 100,000; 95% CI 74.4–84.3) compared with non-Māori (44.4 per 100,000; 95% CI 42.9-46.0). Transport-related incidents were the most common cause of injury (63%), followed by falls (19%).