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Introduction This paper reports the influence of road type and junction density on road traffic fatality rates in U.S. cities. Method The Fatality Analysis Reporting System (FARS) files were used to obtain fatality rates for all cities for the years 2005–2010. A stratified random sample of 16 U.S. cities was taken, and cities with high and low road traffic fatality rates were compared on their road layout details (TIGER maps were used). Statistical analysis was done to determine the effect of junction density and road type on road traffic fatality rates. Results The analysis of road network and road traffic crash fatality rates in these randomly selected U.S. cities shows that, (a) higher number of junctions per road length was significantly associated with a lower motor- vehicle crash and pedestrian mortality rates, and, (b) increased number of kilometers of roads of any kind was associated with higher fatality rates, but an additional kilometer of main arterial road was associated with a significantly higher increase in total fatalities. When compared to non-arterial roads, the higher the ratio of highways and main arterial roads, there was an association with higher fatality rates. Conclusions These results have important implications for road safety professionals. They suggest that once the road and street structure is put in place, that will influence whether a city has low or high traffic fatality rates. A city with higher proportion of wider roads and large city blocks will tend to have higher traffic fatality rates, and therefore in turn require much more efforts in police enforcement and other road safety measures. Practical applications Urban planners need to know that smaller block size with relatively less wide roads will result in lower traffic fatality rates and this needs to be incorporated at the planning stage. [ABSTRACT FROM AUTHOR]