To describe and contrast injury patterns in rural and urban Uganda. One rural and one urban community in Uganda. Community health workers interviewed adult respondents in households selected by multistage sampling, using a standardized questionnaire. In the rural setting, 1,673 households, with 7,427 persons, were surveyed. Injuries had an annual mortality rate of 92/100,000 persons, and disabilities a prevalence proportion of 0.7%. In the urban setting 2,322 households, with 10,982 people, were surveyed. Injuries had an annual mortality rate of 217/100,000, and injury disabilities a prevalence proportion of 2.8%. The total incidence of fatal, disabling, and recovered injuries was 116/1,000/year. Leading causes of death were drowning in the rural setting, and road traffic in the city. Injuries are a substantial burden in Uganda, with much higher rates than those in most Western countries. The urban population is at a higher risk than the rural population, and the patterns of injury differ. Interventions to control injuries should be a priority in Uganda.