BACKGROUND Until early 2003, the Consultative Committee on Road Traffic Fatalities (CCRTF) in Victoria, Australia was the main body investigating and publishing data about prehospital errors resulting from road traffic fatalities. The objective of this study was to identify and interpret prehospital error rate trends associated with road traffic fatalities during a 10-year period of the CCRTF reports. METHODS This study is a review of the prehospital errors defined in Victorian CCRTF reports of preventable deaths of road traffic fatalities over a 10-year period. RESULTS Six CCRTF reports contained prehospital data for errors associated with road traffic fatalities. From 1992 to 1998, system errors decreased. However, over the same timeframe, management, technical, and diagnostic errors increased. There was a marked jump in system, technique, and diagnosis errors from 1998 to 2001-2003. However, management errors declined over the same timeframe. The jump in errors in the 1998 to 2001-2003 timeframe coincided with the introduction of advanced life support (ALS) for Victorian paramedics in 2000.The number of preventable deaths decreased from 1992 to 1998, however, there was an increase from 1999 onwards, coinciding with the introduction of the state trauma system and ALS for paramedics. CONCLUSIONS This study demonstrates that there has been an increase in prehospital error rates, especially from 2000, which coincided with the introduction of ALS for paramedics and the state trauma system in Victoria, even though the state trauma system had an overall decrease in error rates.