An observational cross-sectional study of seatbelt utilization conducted in Kingston, Jamaica, showed 81.2% utilization by private motor vehicle drivers and 74.0%, by front seat passengers. This was significantly improved compared to 21.1% and 13.6% respectively in 1996, before the introduction of legislation in 1999 (p < 0.001). Females were significantly more likely than males to wear seat belts, both when driving (92.5% vs 77.3%; p < 0.001) and as front seat passengers (79.9% vs 66.3%; p < 0 001).