A deadly mix of speed and fatigue has fuelled NSW's worst road toll in three years, with 348 people killed in 2015.
Speed remains the biggest killer, with pedestrian, passenger, motorcycle and P-plater deaths increasing in the past year, says Roads Minister Duncan Gay.
"It's incredibly disappointing, especially considering the amount of resources we've put into driver education and on ensuring high-visibility deterrents are in place," Mr Gay told reporters on Saturday.
The minister said fatigue outstripped drink and drug-driving as the second-biggest cause of deadly crashes.
"Even on short trips you can be at risk, if you played hard over the weekend, of dozing off and losing concentration and losing your life," he said.
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Mr Gay said the government's approach to road safety would be reviewed in the wake of the figures, but stopped short of promising any new laws or specific campaigns.
"We're not going to make radical changes but we will be making changes in particular areas, to pick up the areas where there was a problem," he said.
"There are areas where we need to improve because frankly an increase of 41 (deaths) is not the standard we aspire to."
He said an increase of 20 pedestrian deaths should be a wake-up call to drunk people walking the streets late at night.
"Don't let some poor bloke walk under the path of a car whilst he's paralytic," Mr Gay said.
The data reveals a 33 per cent surge in fatalities on metropolitan roads, but twice as many people are still killed on regional roads.
Centre for Road Safety executive director Bernard Carlon said 16 children were killed on the state's roads in the past year, an increase of nine deaths.
"It really heightens the message that drivers need to be responsible for their passengers," he said.
"We've also had an increase in restraints not being used in cars."
Assistant Police Commissioner John Hartley said officers would maintain a high-visibility presence on the state's roads for the rest of the holiday period.
"Police are targeting drink and drug-driving, speeding, not wearing seatbelts or helmets and fatigue over this period," he said.
"The simple message is drive safely, plan your trip, and make sure you arrive safe and well with your family."
NUMBER OF DEATHS COMPARED WITH 2014:
Total: 348 (up 41)
Pedestrians: 61 (up 20)
Passengers: 60 (up 17)
Motorcyclists: 66 (up 7)
P-plate drivers: 50 (up 16)
* Source: Centre for Road Safety
