Background: Injury is a growing public health problem worldwide. Deaths due to injuries account for 10% of the world’s mortality. More than 90% of the world’s injury deaths occur in low and middle income countries. In Egypt, injury is a hidden epidemic and its related deaths are misclassified due to lack of accurate national data. Furthermore, as a research problem it has also been largely ignored in developing countries. Objectives: To determine the pattern and trend of injury from January 2002 to December 2009 among attendants at trauma unit in Assiut university hospital in Upper Egypt. Patients and Methods: A descriptive retrospective study was conducted at the trauma unit in Assiut university hospital in Upper Egypt. All registered injuries during January 2002 to December 2009 were included in the study. Results: During January 2002 to December 2009, 213835 injured cases were admitted to the trauma unit. The number of attendants increased every year from 9.3% from the total cases in all study period in 2002 up to 15.3% in 2009 with a statistically significant difference (P = 0.000). Young adults aged 20 - 29 years were the most common group affected by injuries (22.2%). Male to female ratio was 3:1. Falls represent one half of injuries (49.6%) from all attended cases, followed by exposure to inanimate mechanical forces (19.5%) and transport accidents (18.3%). Falls were ranked as the leading cause of injuries, while transport accidents were the second cause in 2007 - 2009. Conclusions: Trauma in Upper Egypt is an under-recognized problem, which requires prioritized attention. Increasing the awareness of community, making policies and establishment of a trauma system are important to decrease the burden of injuries.