The Automobile Association says more wire median barriers and lanes are needed on Waikato roads to reduce the number of road deaths.
Thirty-one people have died on Waikato roads this year - double that of any other police district.
In the wider regional council district there have been 36 deaths, Ministry of Transport figures reveal.
The Waikato road deaths make up more than 20% of the country's road toll of 154.
While the overall toll is 66 down when compared to the same time a year ago, there has been no corresponding drop in fatalities in Waikato.
Many deaths have been put down to factors such as speed, alcohol and overtaking, though Automobile Association spokesperson Mike Noon says the sheer volume of traffic also plays a part.
He says the Waikato Expressway needs to be completed, and work to put in wire median barriers and rumble strips should continue as fast as possible. Mr Noon says the onus is also on drivers to adhere to the road rules.
Waikato road policing manager Inspector Leo Tooman says most of the fatal crashes that took place this year were preventable.
In a police operation on Friday night, 2000 cars were stopped during a four hour period on State Highway 1 just north of Huntly.
One man was over the alcohol limit and a number of other infringements were picked up.
Transport Minister Steven Joyce says the government is committed to long-term infrastructure upgrades to bring down the road toll in Waikato.
Mr Joyce says the quality of roading in the region is partly to blame.
"State Highway 1 through the Waikato is very under-spec. It needs to be a divided four-lane expressway. That will not only improve the safety on that road, but on a number of roads that run parallel to it, which are used effectively by drivers at this point as rat runs and that causes problems for all the local traffic as well."
He says a full upgrade of the expressway will take 10 years but the Government has introduced a number of stopgap measures, including policing and education, in the meantime.