India, the world’s largest democracy and second most populous country, is in the midst of an economic boom with gross domestic product growth averaging nearly 8% over the past several years despite a worldwide recession. The World Health Organization (WHO) has predicted that trauma case related deaths in India will move from ninth position up to the third position by 2020. The organization structure for an improved national trauma system in India will depend on a national inclusive strategy supported by resources and funding within a service quality framework to win public trust. This must include an integrated nationally coordinated approach to the organization of pre-hospital care facilities, hospital networking and communication systems, and the organization of in-hospital care.