INTRODUCTION: Sub-Saharan Africa (SSA) has an injury mortality rate among the highest in the world. Preliminary work suggests prehospital care may be a modifiable factor key to reducing trauma mortality in low- and middle-income countries, but data in SSA are limited. Using a prospective, multisite trauma registry from Cameroon, we compared outcomes among injured patients who did and did not receive prehospital care. We hypothesized that receiving prehospital care was associated with increased early trauma survival. METHODS: Patients enrolled in the Cameroon Trauma Registry between 2017 and 2019 were divided into prehospital care (PC) and no prehospital care (NPC) cohorts. Demographics, injury characteristics, socioeconomic status (SES), clinical data, and outcomes were compared. Multivariate logistic regression was used to explore association between PC and early hospital survival. RESULTS: Among 9,464 injured patients, 14% (n = 1,372) received PC and 86% (n = 8,092) did not. Compared with NPC patients, PC patients had higher SES (p < 0.001) and more penetrating injuries (60% vs 38%, p < 0.001). Median highest estimated abbreviated injury severity was higher among PC patients (3 vs 2, p < 0.001). Multivariate logistic regression adjusted for age, sex, SES, injury severity, and mechanism found receiving PC to independently predict survival (odds ratio [OR] 6.3, 95% CI 3.4–11.8). Among 3,951 patients with penetrating injury, receiving prehospital bleeding control with pressure was independently associated with survival (OR 9.1, 95% CI 4.0–20.5; Figure).FigureCONCLUSION: PC, particularly bleeding control after penetrating injury, independently predicts early trauma survival in Cameroon. Prehospital intervention, such as training programs, have the potential to improve trauma outcomes in SSA.