Background: There remains a dearth of cross-city comparisons on the impact of climate change through extreme temperature and precipitation events on road safety. We examined trends in traffic fatalities, injuries and property damage associated with high temperatures and heavy rains in Boston (USA) and Santo Domingo (Dominican Republic). Methods: Official publicly available data on daily traffic outcomes and weather conditions during the warm season (May to September) were used for Boston (2002-2015) and Santo Domingo (2013-2017). Daily maximum temperatures and mean precipitations for each city were considered for classifying hot days, warm days, and warm nights, and wet, very wet, and extremely wet days. Time-series analyses were used to assess the relationship between temperature and precipitation and daily traffic outcomes, using a quasi-Poisson regression. Results: In Santo Domingo, the presence of a warm night increased traffic fatalities with a rate ratio (RR) of 1.31 (95% CI [confidence interval]: 1.00,1.71). In Boston, precipitation factors (particularly, extremely wet days) were associated with increments in traffic injuries (RR 1.25, 95% CI: 1.18, 1.32) and property damages (RR 1.42, 95% CI: 1.33, 1.51). Conclusion: During the warm season, mixed associations between weather conditions and traffic outcomes were found across Santo Domingo and Boston. In Boston, increases in heavy precipitation events were associated with higher traffic injuries and property damage. As climate change-related heavy precipitation events are projected to increase in the USA, the associations found in this study should be of interest for road safety planning in a rapidly changing environment.