BACKGROUNDThe e-scooter has become an alternative mode of transport in urban areas, and this has led to a rising number of injuries. There is a lack of comprehensive, nationwide data on severe injuries due to e-scooter accidents.METHODSFrom 2020 onward, e-scooter accidents have been recorded as a separate subgroup in the multicenter TraumaRegister DGU (TR-DGU) (DGU = German Trauma Society). In this study, we analyzed the data from 2020-2023 and compared them with data for bicyclists and other road users.RESULTSWe compared data on 538 persons who were severely injured in e-scooter accidents with data on injured bicyclists and other road users. Compared to cyclists, e-scooter accident victims were more often male (78.4% versus 72.3%), younger (44.3 versus 54.5 years) and more often under the influence of alcohol (34.9% versus 15.6%). More than half of the accidents (54%) took place at night, and 83% of the e-scooter accident victims suffered a severe injury to the head or face (Abbreviated Injury Scale [AIS] ≥ 2). The most common injuries were subarachnoid hemorrhage (20.1%), skull base fracture (16.7%), and serial rib fractures (16.5%). 83.5% of these e-scooter accident victims were treated in intensive care; the average length of hospital stay was 7 days (interquartile range, 4-12 days). 26 (4.8%) of the e-scooter accident victims died.CONCLUSIONE-scooter accidents cause severe injuries to the head and face. Middle-aged men are most commonly affected. The victims are often under the influence of alcohol, need intensive care, and have an appreciable mortality. Measures should be taken urgently to educate e-scooter riders and improve safety.