More than 75 000 people are killed each year on rural roads in OECD countries; this represents about 60% of fatal road crashes. This loss of lives has an economic cost of around US$135 billion per year. The relative share of rural road fatalities in total road fatalities has risen from less than 55% in 1980 to more than 60% in 1996. While there has been a reduction in the total number of road fatalities in OECD countries during the past 20 years, it is clear that safety improvements on motorways and urban roads have been more successful than those on rural roads. Following an in-depth review of the characteristics of road crashes in rural areas, the book proposes a series of safety measures, focusing on infrastructure management, enforcement, innovative tools, such as intelligent transport systems, and trauma management. The book strives to raise the awareness of road users, decision makers and politicians of the importance of road safety in rural areas. It is a very useful handbook for local, regional or national authorities seeking to improve -- sometimes at very low cost -- safety on rural roads.