Motor vehicle crashes (MVC) are a leading cause of death (average 682 per year) and serious injury in Oklahoma. In 1993, Oklahoma ranked 12th in the nation in motor vehicle deaths, ranking 35% above the national average. Data suggests 782 Oklahomans who died in motor vehicle crashes from 1993 to 1995 could have been saved by seat belts. Persons who survive a MVC with a serious traumatic brain or spinal cord injury often have long-term and costly problems (Table 1). The Oklahoma Mandatory Seat Belt Law (O.S. 47-12-417) requires the driver and front seat passengers to be restrained by a seat belt system, however, law enforcement officers can only cite a driver for a seat belt violation when another violation such as speeding has occurred (secondary enforcement). Oklahoma's high death rate and low (46%) seat belt usage rate as compared to a national average of 67% is typical of states that do not have primary enforcement laws that allow citation of drivers solely on the basis of a seat belt violation. Public health professionals and safety advocates must continue to educate the public about the absolute benefits of wearing seat belts.