PURPOSES : According to government data, the Black Spot Program has resulted in an average 28.8% reduction in traffic accidents within one year of project implementation in areas where road conditions improved. However, there has been a lack of in-depth analysis of the midto- long-term effects, with a predominant focus on short-term results. This study aimed to analyze the mid-to-long-term effects of the Black Spot Program to assess the sustainability of its reported short-term impact. Additionally, the differences in the mid-to-long-term effects were investigated based on the scale of traffic accidents at intersections and the characteristics of these effects are revealed. METHODS : The mid-to-long-term effects of the Black Spot Program were analyzed at 122 intersections in Seoul, Korea, where the program was implemented between 2013 and 2017, using traffic accident data spanning five years before and after implementation. Additionally, the differences in the program's effects were analyzed at the top-100 intersections with the highest traffic accident concentration in Seoul using the chi-square test to identify these differences. To theoretically validate these differences, the Hurst exponent, commonly used in economics, was applied to analyze the regression to the mean of the intersections and reveal the correlation with improvement. RESULTS : Through the Black Spot Program at 122 intersections, a 33.3% short-term accident reduction was observed. However, the midto- long-term effect analysis showed a 25.8% reduction, indicating a slightly smaller effect than previously reported. Specifically, the top-100 intersections exhibit a 15.4% reduction. A chi-square test with a 95% confidence level indicated significant differences in the program’s effects based on the scale of traffic accidents at intersections. The Hurst index (H ) was measured for the top-100 intersections, yielding H = 0.331. This is stronger than the overall H = 0.382 for all intersections in Seoul, suggesting that the regression to the mean is more pronounced, which may lead to a lower effectiveness of the improvement. CONCLUSIONS : The mid-to-long-term effects of the Black Spot Program were relatively lower than its short-term effects, with larger differences in effectiveness observed based on the scale of traffic accidents at intersections. This indicates the need to redefine the criteria for selecting project targets by focusing on intensive improvements at intersections, where significant effects can be achieved.