In the course of the twentieth century road traffic injuries (RTIs) became a major public health burden. RTI deaths first increased in high-income countries and declined after the 1970s, and they soared in low- and middle-income countries from the 1980s onwards. As motorisation took off in North America and then spread to Europe and to the rest of the world discussions on RTIs have reflected and influenced international interpretations of the costs and benefits of ‘development’, as conventionally understood. Using discourse analysis, this paper explores how RTIs have been constructed in ways that have served regional and global development agendas and how ‘development’ has been (re-)negotiated through the discourse of RTIs and vice versa. For this purpose, this paper analyses a selection of key publications of organisations in charge of international health or transport and places them in the context of (a) the surrounding scientific discussion of the period and (b) of relevant data regarding RTI mortality, development funding, and road and other transport infrastructure. Findings suggest that constructions of RTIs have shifted from being a necessary price to be paid for development to being a sign of development at an early stage or of an insufficiently coordinated development. In recent years, RTI discussions have raised questions about development being misdirected and in need of fundamental rethinking. At present, discussions are believed to be at a crossroads between different evaluations of developmental conceptualisations for the future.