This study has investigated secondary collisions following an initial barrier impact in tow-away level crashes. The analysis included 2026 barrier impact cases that were selected from 12-years of in-depth crash data available through the National Automotive Sampling System (NASS) / Crashworthiness Data System (CDS). Secondary collisions were found to occur in approximately one-third of tow-away level crashes where a traffic barrier was the first object struck. Secondary crashes were found to primarily involve an impact to another vehicle, an impact to another barrier, or a rollover; tree and pole impacts were found to represent a much smaller proportion of secondary impacts. Through a detailed analysis of vehicle trajectory, this study supports previous research suggesting secondary collision risk is substantial even for vehicles not ultimately involved in a secondary collision. Compared to a single barrier impact, the occurrence of a secondary collision was found to increase the risk of serious occupant injury by a factor of 3.5, equivalent to the serious injury risk difference found between a belted and unbelted occupant in a traffic barrier crash.