This study conducted detailed case reviews of fatally injured belted drivers and front row passengers in frontal crashes in the United States. Cases were identified using the NHTSA’s NASS-CDS, CISS, and CIREN databases. Although this study includes model year 2000 and newer vehicles, greater emphasis was placed on evaluating newer vehicles. A consensus panel reviewed each case and assigned influential factors that contributed to the fatal outcome. The influential factors included characteristics such as exceedingly severe, limited structural engagement, narrow object impact, heavy vehicle underride, and occupant specific factors. These categories generally aligned with prior studies and allowed case reviewers to characterise the fatalities in terms of high-level, crashworthiness-related themes. Results indicate that conditions of limited structural engagement and exceedingly severe are still the most common factors among fatally injured belted occupants in frontal crashes. Occupant specific factors, especially among female occupants, stood out more prominently in this study.