The aim of this paper is to propose a critical review on setting and achieving road safety targets as the key means for the improvement of road safety in Europe. The results of the most recent research projects concerning the effectiveness of road safety measures implemented in countries with different economic development level and road safety performance are examined. Specifically, the results of a research project undertaken by the Joint OECD/ ITF Transport Research Centre (JTRC) on “Achieving Ambitious Road Safety Targets” are reviewed. Additionally, the results of the 1st and the 2nd Strategic Plan for the improvement of road safety in Greece, conducted by NTUA, and of other relative European research projects are reviewed. The processes of setting and achieving road safety targets in many European countries were examined, followed by a synthesis of the role of road safety targets in setting priorities and implementing integrated road safety strategies in these countries. Barriers to the implementation of effective road safety strategies and countermeasures are specially discussed. The results of this research will allow the suggestion of best practices to address traditional road safety problems and emerging issues through the use of specific quantitative targets, as well as successful implementation of road safety strategies with emphasis to their introduction in Greece.