BACKGROUND: Injuries make up a significant portion of the emergency surgical patient load in most hospitals, representing a major public health threat The burden of injury as a public health issue is especially pronounced in low- and middle-income countries, where injuries are responsible for up to 90% of mortality. Identifying common mechanisms of trauma and patterns of presentation can aid in identifying at-risk populations and in the development of targeted preventive protocols. METHODS: From February 2000 to January 2015, a prospective observational study was conducted to examine the patterns of presentation and epidemiology of patients presenting to the surgical emergency department of a University Teaching Hospital. All patients who presented during these 15 years were enrolled in the study. RESULTS: A total of 27,588 patients were admitted through the surgical emergency department during the study period. Of these, 18,374 patients (66.6%) presented with trauma, while the remaining 33.4% sought care for other surgical emergencies. Trauma patients were generally younger, with an average age of 30.27 years, compared to an average age of 41.33 years for those presenting with other surgical emergencies. Road traffic crashes accounted for the majority of injuries (65.3%), followed by falls (8.9%) and assaults (6.9%). The majority of patients (69.2%) were transported to the hospital by friends and relatives. CONCLUSION: Injuries represent a substantial portion of the emergency surgical care demands in this setting. Road traffic injuries continue to be the predominant cause of trauma, with young adult males being the most frequent victims.