Egocentricly comprehending the causes and effects of car accidents is crucial for the safety of self-driving cars, and synthesizing causal-entity reflected accident videos can facilitate the capability test to respond to unaffordable accidents in reality. However, incorporating causal relations as seen in real-world videos into synthetic videos remains challenging. This work argues that precisely identifying the accident participants and capturing their related behaviors are of critical importance. In this regard, we propose a novel diffusion model Causal-VidSyn for synthesizing egocentric traffic accident videos. To enable causal entity grounding in video diffusion, Causal-VidSyn leverages the cause descriptions and driver fixations to identify the accident participants and behaviors, facilitated by accident reason answering and gaze-conditioned selection modules. To support Causal-VidSyn, we further construct DriveGaze, the largest driver gaze dataset (with 1.54M frames of fixations) in driving accident scenarios. Extensive experiments show that Causal-VidSyn surpasses state-of-the-art video diffusion models in terms of frame quality and causal sensitivity in various tasks, including accident video content editing, normal-to-accident video diffusion, and text-to-video generation.