Abstract
India has one of the highest rates of road traffic accidents (RTAs) globally. Mass gatherings significantly amplify this burden due to increased vehicular movement, crowd congestion, and infrastructural strain. We conducted a retrospective study to assess the impact of Kumbh Mela 2025, one of the largest documented human congregations, on RTA-related injuries. Retrospective, hospital-based study at a Level-1 trauma center comparing trauma cases in a 15-day Kumbh period versus a 25-day pre-Kumbh baseline. Poisson regression on baseline data estimated expected case counts for the Kumbh period; observed versus expected cases were compared. The Kumbh period saw 202 trauma cases versus 181 predicted (12% surge). RTAs were the predominant cause of injuries, contributing substantially to maxillofacial trauma cases. National projections assumed 400-600 million pilgrim journeys. Based on regression projection model, there was a 42% injury reduction from safety interventions. Trauma incidence rose modestly during Kumbh Mela 2025, but targeted road safety measures mitigated potential harm. Mass-gathering preparedness with evidence-based interventions can yield significant public health benefits, informing policy for safer large events in India.