On May 11, 2023, about 1420 eastern daylight time, a Cessna 172N, N1596E, was substantially damaged when it was involved in an accident near South Bethlehem, New York. The private pilot and one passenger suffered serious injuries, while a second passenger incurred minor injuries. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. The pilot reported that his injuries included a vertebrae fracture and concussion, and he could not recall the accident sequence. A pilot-rated witness reported that the airplane was attempting to take off from runway 19 at South Albany Airport (4B0), South Bethlehem, New York. Runway 19 was 2,853 ft-long, 60 ft-wide, and consisted of asphalt. About 15 minutes before the accident takeoff, another Cessna 172 performed a tailwind takeoff on runway 19 uneventfully; however, that airplane started its takeoff roll at the beginning of the runway. The accident airplane took off beginning at a runway intersection, with about 2,293 ft of runway remaining, in an approximate 9-kt tailwind, gusting to 13 or 14 kts. The accident airplane subsequently impacted a field near the departure end of runway 19 and came to rest upright. Examination of the wreckage by a Federal Aviation Administration inspector revealed substantial damage to the left wing and fuselage. The inspector observed the flaps in the retracted position and did not note evidence of any preimpact mechanical malfunctions. Following the wreckage recovery to a storage facility, recovery company personnel were able to rotate the propeller by hand, confirm powertrain continuity to the rear accessory section, and attain thumb compression on all cylinders. Review of weight and balance data for the airplane revealed that it had a useful load of 820 lbs. The reported occupant weights totaled about 740 lbs., leaving 80 lbs for fuel and baggage. The amount of fuel onboard and weight of the baggage was unknown. Review of performance data from a make and model pilot operating handbook revealed that, at maximum gross weight and in the reported wind and temperature conditions, the airplane required about 2,300 ft of runway to take off and clear a 50-ft obstacle. There were no performance data for any tailwind greater than 10 knots or any weight above the maximum gross weight.