In the global context, about 1.25 million people die each year as a result of road traffic crashes. Moreover, road traffic injuries are the leading cause of death among young people, aged 15–29 years. Furthermore, 90% of the world's road fatalities occur in low- and middle-income countries (WHO, 2017). In Sri Lanka, the accident rate is increasing rapidly. According to the transport and civil aviation report, 2801 deaths, 2590 fatal accidents, 13,095 minor accidents, and 7719 critical accidents occurred in Sri Lanka in 2015. The trend of the accidents has been increasing due to many factors. Physical features of the roads and roadsides, behaviour of drivers and pedestrians are the main influence on the occurrence of accidents. Central province has many accidents-prone areas due to its spatial and temporal patterns. Landform and climatic factors such as fog, snow and rainfall trigger accident potentials. Therefore, this study, “Spatial and temporal patterns of road accidents and their challenges: a study on Nuwara-Eliya District” investigates reasons for the enhanced rate of traffic mishaps. This is the first such study of this phenomenon. Herein, we used primary and secondary data. The results indicate that physical features are mainly to blame.