This paper presents the results of studies conducted in Delhi, India, on the pattern of motorized-two-wheeler and helmet use patterns, injuries to twowheeler crash victims hospitalised in a neurosurgery ward, police reported fatal crashes and biomechanical evaluation of crash involved motorcycle helmets. The results indicate that in the absence of a law education alone does not convince riders to use helmets in Delhi and that lack of driver training does not seem to be a factor contributing to serious injury and fatal crashes. Conspicuity and better helmet design are the two most important safety measures for motorcycle and scooter riders.