Injuries, whether intentional or unintentional, are the third leading cause of death in the WHO European Region and pose a threat to economic and social development. Comprehensive policies for injury prevention are a means of organising the actions of different stakeholders and sectors towards achieving the shared objective of preventing injuries. In Europe, the development of comprehensive national policies is advocated by both the WHO Regional Committee resolution EUR/RC55/R9 and the European Council Recommendation on the prevention of injuries and promotion of safety. This article presents an overview of progress achieved by European Member States in implementing these policy recommendations, and some more general reflection on the challenges and opportunities faced in preventing injuries and violence in the Europe. Much progress has been made, with the development of national policies for preventing individual types of injury and violence ranging from 86% for road safety to about one third for preventing youth violence and self-inflicted violence. Countries were assessed as to whether they were implementing any of 69 evidence-based injury and violence prevention programmes selected from the literature. Progress in implementing these varied in different countries, and the median was 56% for the 31 responding countries taken together. Although overall encouraging progress is taking place, the health sector needs to commit more to the widespread implementation of effective programmes, and to engage with other stakeholders in a multisectoral response to prevent injuries. This should include the development of an overarching strategic framework for action, as well as the development of strong evidence-based arguments towards making injury prevention a compelling case for policy makers to act upon, particularly in view of the large gap in safety inequality uncovered by research.