The Utah Department of Health established a state-wide registry of spinal cord injuries (SCIs) occurring in 1989-1991, analyzing data from hospital medical records and police reports. Forty-nine percent of all SCIs involved motor vehicles. Adolescent and young adult males were at highest risk of injury. Among occupants of automobiles and trucks, 70 percent were involved in a vehicle rollover, while 38 percent were ejected from the vehicle. Only 25 percent reported using seatbelts. SCIs were much more likely to be associated with rollover compared with other types of motor vehicle occupant injuries. These findings suggest areas in which SCI prevention programs and research should be focussed.