Injuries trends of passenger car drivers in head-on collisions are identified based on crash data extracted from the National Automotive Sampling System. Annual injury incidence levels are estimated for years 1990–2007. Over that period, the number of crashes is predicted to rise by 71%. However, the number of serious injuries to drivers is expected to rise by only 41% and driver fatalities are anticipated to decrease by 9%. Meantime, the types of injuries suffered by drivers are changing. Year-to-year shifts in injury patterns result from changes in vehicle size classes within the US vehicle fleet population and increases in seat belt use and air bag availability. The effectiveness of air bags in saving lives is estimated to be 30%, and with more air bag-equipped cars on the road, the probability of sustaining a life-threatening head or a torso injury is reduced. Air bags, however, are not as effective in preventing upper and lower extremity injuries, and thus arm and leg injuries will become more prevalent in years to come.