This study examined the clinical characteristics and causes of death among bicycle injury patients who visited an emergency room. From August 2006 to December 2013, we collected data on the injured patients including age, sex, AIS, ISS, death rate, and so on. Among 1.023 patients treated in an emergency room during the period, 341 (33.3%) were hospitalized, 47(4.6%) received an emergency surgery, and 23 (2.2%) died. It is also found that only 7.1% of those patients wore helmet. Most of the patients had injuries on limbs, pelvis, and head and neck, and the death rate among patients with head and neck injuries appeared to be high. The findings of this study highlight a need of a better understanding on the severity of bicycle injuries and suggest active promotion of wearing protecting equipment along with policy establishment. The findings of this study highlight a need of a better understanding on the severity of bicycle injuries and suggest active promotion of wearing protecting equipment along with policy establishment and required.