Résumé : Background: in Benin, due to the unavailability of comprehensive data on road crashes, road safety policies are mainly based on partial statistics provided by the police. These remain unreliable in terms of injury severity and risk factors. This study aims to determine the factors influencing the severity of injuries after a road crash in Benin. Methods: the present nested case-control study, matched for age and sex, was based on a hospital cohort of road crash victims set up in five hospitals in Benin between July 2019 and January 2020. A sample of severely injured patients according to the Abbreviated Injury Scale (AIS) (cases) was compared to non-severely injured patients (controls). Results: the severe crash occurred mainly during the night between 8 p.m. and midnight (36.2% of cases vs. 24.4% of controls) and on main roads (57.8% of cases vs. 34.7% of controls). Factors associated with injury severity were time of the crash: night between 8 p.m. and midnight (Adjusted Odd Ratio (AOR): 2.1; CI 95%: 1.4-3.2), major roads (national interstate roads and national roads) (AOR: 2.8; CI 95%: 2.0-4.0) and non-work related travel (AOR: 1.8; CI 95%: 1.2-2.7). Conclusions: factors associated with road crash severity in Benin were nighttime, main roads and non-work related travel. Raising user awareness about compliance with traffic rules and improving public lighting, especially along main roads could help reduce the number of serious injuries.