Head restraint positioning was examined for drivers in the United States and front seat passengers in both the United Kingdom and the U.S.. Video footage of real world driving situations was analyzed to provide data on the position of head restraints, together with details of occupant and vehicle characteristics. At least 88% of occupants had the restraint positioned too low, and in at least 24% of cases the restraint was too far from the head horizontally. These findings have serious implications for safety, particularly in rear impacts. There is, therefore, a need to improve head restraint design and the arguments for smart restraints are examined.