There are many challenges in establishing surveillance systems for road injuries in India, predominantly rapid staff turnover, heavy workload and the absence of already existing data recording and management in hospitals. Pending administrative solutions such as improved staffing and posting, the chief measures to address these challenges were sustained dialogue and rapport-building with hospital administrators, training of data collectors, and enlisting the aid of bridge personnel, such as interns. Reiterating the value of surveillance data to negotiate for hospital resources commensurate with the high burden of road injuries may help convince hospital administrators to sustain such surveillance initiatives.