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The official Indian accident statistics show that the number of road accidents and fatalities are one of the highest worldwide. These official statistics provide important facts about the current accident situation. It is suspected that for various reasons not all accidents are reported to the official statistic. This study estimates the degree of underreporting of traffic accidents with casualties in India. In order to get a national overview of the traffic accident situation it is necessary to improve the knowledge about underreported accidents. Therefore, the in-depth accident database of “Road Accident Sampling System India” (RASSI) was analyzed [1]. This project is organized by a consortium that has collected traffic accidents scientifically in four different regions since 2011 on the spot which have been reported either by police or by local hospitals and own patrol by RASSI engineers.