Bangladesh has a very serious and deteriorating road safety problem. While about 4000 deaths annually are reported to the police, it is estimated that over 10,000 deaths resulting from road crashes occur annually. Bangladesh with the lowest motorization level has the worst fatality rate (deaths/10,000 motor vehicles) of the region. The annual socio-economic costs represent around 2% of GDP. The most vulnerable road users - pedestrians, poor people and children suffer the most serious consequences of road traffic crashes. Road crashes are the leading cause of death for children aged between 10-14 years. The tragic, premature costly loss of life and permanent disability is hindering poverty reduction efforts particularly in rural areas. The number of reported traffic fatalities increased nearly 4 times over the last 26 years, 1982-2008. Road safety improvement efforts in Bangladesh however seriously suffer from several weaknesses and serious drawbacks. There is an urgent need to accelerate implementation of problem specific countermeasures, policies and conduct of good practice based on efforts of enhanced understanding, scientific analysis, monitoring and research. Effective road safety management across government needs to be established urgently and on a sustainable basis. Creating an effective organization dedicated to ownership and initiating and coordinating road safety activities is fundamentally important. All sectors will need to be motivated and engaged by activating lead agencies with a mandate of implementing very specific and explicit actions and strategies towards delivery of agreed visions, goals and targets. There is an urgent need to plan, design and implement an effective and sustainable institutional structure to address road safety challenges. In this paper an attempt has been made to discus these aspects of road safety organizational arrangements. Some of the issues, challenges and opportunities in road safety management, institutional arrangements and the development of professional capability, knowledge and expertise through imparting training and sharing experience are also discussed in the paper.