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Major trauma (MT) from road traffic crashes is a great burden to global health. Analyses of MT using hospital-based samples are normally selected at the patient level using an Injury Severity Score (ISS) above 12 or 15, and in-hospital fatalities. This likely underestimates the number of injured people requiring medical care from MT crashes.The objective was to determine the true number of people injured in MT crashes in Sweden. Data from April 2011 to March 2017 was retrieved from the Swedish Traffic Accident Data Acquisition (STRADA) which is a matched hospital and police national database. First, MT patients were selected from emergency department (ED) data where at least one patient was transported by ambulance with an ISS >12 or died in hospital. Then, matched individuals in the same MT crashes were added to the sample.The sample was based on 2,542 MT patients from 2444 road crashes. An additional 1012 non-MT patients or fatalities were presented to the ED’s. Of these ED patients, 884 (87.4%) were transported by ambulance and 488 (48.2%) were admitted to hospital. The police reported 1,383 MT crash participants beyond those presenting to the ED. In total, there were 4937 road users exposed to a MT crash.The burden of MT crashes on the society and the health care system is much larger when including all road users from these crashes. The matched crash data revealed an increase of ED presentations by 39.8% and ambulance transportations by 34.8%. To understand the full extent of MT crashes, governments need to provide better opportunities for data linkage across authorities to better guide crash and injury prevention.