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Road traffic injuries are the leading cause of death among young people aged 15–29 years. In Gunungkidul district, number of road traffic accidents tend to increase and become the 3rd highest problem in Gunungkidul. Gunungkidul district is the largest rural area in Yogyakarta province which has hilly topography so the road condition is very risky for a crash. This study was aimed to conduct further analysis of road traffic accidents fatality and identify road traffic accident-prone location using Geographic Information System.This was a cross-sectional study. Sample was all road traffic accident recorded in Gunungkidul Police Departement from January 1 st to December 31 st 2015 that met inclusion criteria (377 accidents). Road traffic accidents fatality was analyzed using poisson regression with robust variance and road traffic accident-prone location was analyzed spatially using ArcGIS 10.4 with optimized hot spot analysis method.Of all 377 road traffic accidents, 63 were fatal crash (17%). The result revealed that 00:00–05:59 a.m was time with highest fatal crash. Uphill/downhill road geometric (PR 2.2: 95% CI 1.14–4.10) and winding road (PR 1.8; 95% CI: 1.02 to 3.21) and also single crash (PR 3.6;95% CI 1.95–6.59) were significant factors affecting road traffic fatality. Accident-prone locations to traffic accidents in Gunungkidul are clustered on Yogyakarta-Wonosari road, Karangmojo-Semin road, Wonosari-Semanu road and Wonosari-Baron road.Fatal road traffic accident in Gunungkidul are influenced by environmental conditions and accident types. Multisectoral coordination was needed to make efforts to modify the environment related to road geometric conditions to minimize the occurrence of road traffic accidents.