This study examined the morbidity and mortality from bicycling injuries in Wuhan, China. Police department data for the year 1993 complemented by data from emergency room interviews were analyzed. The death rate from bicycling injuries was estimated as 2.2 per 100000 population, more than seven times the rate for the United States. At least 79% of the fatalities and 17% of the emergency room cases sustained head injuries, the majority (71%) of which resulted from contact of the head with the concrete or asphalt road. None of the patients was wearing a helmet at the time of injury, and helmet use among the general bicyclist population was nonexistent. Bicycle-related head injury is an important public health issue in China. The effectiveness of safety helmets in developing countries needs to be evaluated.