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The relationship between car size and occupant injury is examined using traffic accident data from all over Japan. For head-on collisions, the occupant injury rate is formulated based on the approximation of occupant injury by delta-V. The effects on occupant injury of the sizes of the striking and struck vehicles, as well as the effects of seat belt use and vehicle velocity, are examined in head-on, side-impact and single-car collisions. As occupant injuries are also influenced by the other car or cars involved in a collision, the number and size distribution of vehicles is important. Sensitivity analysis shows that the effect of the number of lighter cars is greater in head-on collisions and that the effect of the number of heavier cars is greater in side-impact collisions, relative to the total number of fatalities.