ObjectiveThis study explored the temporal and spatial trends in road traffic fatalities in Shandong Province from 2001 to 2019 and discusses the possible influencing factors.MethodsWe collected data from the statistical yearbooks of the China National Bureau of Statistics and the Shandong Provincial Bureau of Statistics. Join-point Regression Program 4.9.0.0 and ArcGIS 10.8 software were used to analyze the temporal and spatial trends.ResultsThe mortality rate of road traffic injuries in Shandong Province decreased from 2001 to 2019, with an average annual decrease of 5.8% (Z= −20.7,P< 0.1). The three key time points analyzed in the Join-point regression model roughly corresponded to the implementation times of traffic laws and regulations in China. The temporal trend in case fatality rate in Shandong Province from 2001 to 2019 was not statistically significant (Z= 2.8,P< 0.1). The mortality rate showed spatial autocorrelation (global Moran’sI= 0.3889,Z= 2.2043,P= 0.028) and spatial clustering. No spatial autocorrelation was observed in the case fatality rate (global Moran’sI= −0.0183,Z= 0.2308,P= 0.817).ConclusionsThe mortality rate in Shandong Province decreased significantly over the studied period, but the case fatality rate did not decline significantly and remains relatively high. Many factors influence road traffic fatalities, among which laws and regulations are the most important.