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BACKGROUND: Timely delivery of emergency care and reducing the transmission time of injured people to health centers is very effective in reducing the number of deaths and injuries in accidents. The purpose of this study was to evaluate the factors affecting road traffic accident relief in Iran with an emphasis on air transport. METHODS: The present study was performed through resorting to Multiple Attribute Decision Making (MADM) statistical techniques and operation research like analytic hierarchy process (AHP) by means of establishing hierarchy process, pairwise comparisons, combining weights, analyzing sensitivity, and ranking method, which were compatible with the research methods and type of variables. The study population consisted of 3759 managers, faculty members, experts in the field of rescue, and relief, and traffic users. 349 participants were selected using Cochran sampling method. They answered a researcher-made questionnaire about the factors affecting road traffic accident relief in Iran, which validity and reliability were approved. The collected data and research hypotheses were considered through statistical test. Expert Choice software was used to facilitate the process of research. RESULTS: Human factors, equipment factors, managerial factors, and environmental conditions criteria with relative weights of 0.3810, 0.3738, 0.2149, and 0.0303, respectively, had the highest effect on human casualties in rescue operations. Assessment of sub-criteria showed that the lack of a functional structure and appropriate organization to lead rescue operations, emergency and hospital personnel with lack of enough expertise and skill, and delays in rescue and increase in the time of rescue had the first places of importance, respectively. Finally, prioritizing rescue operations based on the type of transportation indicated that air emergency, ground emergency, and Red Crescent rescue and relief, had respectively the first, second, and third places in affecting the decrease in human casualties. CONCLUSION: Lack of expertise and skills of staff, equipment failure, and lack of systematic structure in relief systems have increased damage to the injured, and by creating substructure, air rescue is a priority in reducing human casualties compared to land relief.