Motorized two-wheelers, particularly motorcycles and scooters, contribute significantly to road traffic injuries and deaths in low- and middle-income countries. This study aimed to assess the magnitude, determinants, and outcomes of two-wheeler crash accidents. A systematic review and meta-analysis were conducted following PRISMA guidelines using PubMed, Scopus, Cochrane, and Google Scholar databases. Forty studies (2012–2018) were analyzed to determine national and provincial patterns.  Across 40 studies, 50,283 road traffic accidents were reported, of which 41,596 (83%) involved motorized two-wheelers. Punjab accounted for 43.4% of all two-wheeler crashes and a higher share of severe outcomes: 59% fatal, 68.8% deaths, and 62.8% disabling injuries. Contributing factors included excessive speed, poor helmet compliance, inadequate infrastructure, and delayed emergency care Motorized two-wheeler crashes represent a major public health issue in Pakistan, especially in Punjab. Strengthened helmet enforcement, road safety education, improved infrastructure, and enhanced trauma response are essential to reduce this preventable burden.

Keywords- motorized two-wheelers, meta-analysis, road traffic injuries, systematic review