Context:​ Motor vehicle (MV)-related injury is a leading cause of death and emergency department visits in the US. Information has been limited regarding the magnitude and types of injuries suffered by the survivors of MV crashes.

Objective:​ To estimate the incidence and patterns of neck strain/sprain injury among MV occupants treated in US hospital emergency departments.

Design and participants:​ Descriptive epidemiologic analysis of persons treated at a stratified, probability sample of US hospital emergency departments from 1 July to 31 December 2000.

Setting:​ US.

Main outcome measures:​ Annualized national estimates of number and rate of neck strain/sprain injury among MV occupants overall and by patient’s age and sex. Rates were calculated per 100,000 population as well as per billion person miles traveled.

Results:​ In 2000, an estimated 901,442 (95% CI 699,283–1,103,601) persons with neck strain/sprain injury were treated in US hospital emergency departments. For MV occupants, neck strain/sprain was the most frequent type of injury, comprising 27.8% of all injuries to MV occupants treated in emergency departments that year. The incidence (per 100,000 population) of neck strain/sprain was significantly lower in younger children and peaked in the 20–24-year age group. The incidence (per billion person miles traveled) peaked in the 15–19-year age group. Females tended to have a higher incidence of emergency department-treated neck strain/sprain than males.

Conclusions:​ Neck strain/sprain is the most common type of injury to MV occupants treated in US hospital emergency departments. Based on emergency department visits, these estimates suggest that the problem of neck injury may be larger than has been previously demonstrated using other surveillance tools. Further research is needed to determine contributory factors and prevention measures to reduce the risk of neck injury among MV occupants especially among those at higher risk such as females, older teenagers and young adults.