Terror-related injuries are becoming more prevalent. The predominant mechanism of damage is related to blast effects. These include penetrating injury due to material in the explosives and blunt trauma due to objects falling after detonation. However, the more commonly encountered severe trauma in civilian centres is related to motor vehicle accidents. A comparison between the two, although problematic, might enhance the knowledge of orthopaedic traumatologists dealing with these injuries. Thus 1072 in-patients, treated in levels I and II centres in Israel for orthopaedic injuries due to terrorist attack from November 2000 to December 2003, were compared with 9714 similar in-patients injured in motor vehicle accidents (controls). Analysis included age, gender, severity of injuries, diagnoses, lengths of intensive care unit and hospital stay, operations and mortality. The victims of terrorist attack included significantly more young adults, males, severe associated injuries and operations, and increased lengths of stay and mortality. Prompt recognition and awareness of the unique character of terror-related injuries is required.