This publication assesses countries’ laws and practices on key risk factors – such as regulating speed appropriate to road type, drink–driving, and use of seat belts, motorcycle helmets and child restraints – for their effectiveness in reducing the risk injury. The assessment shows that many countries need to strengthen their road safety legislation and its enforcement to protect their populations, improve road users’ behaviour and reduce the number of crashes. For example, while comprehensive laws on seat belts in line with best practice cover 95% of the Region’s population, laws for speed adequately protect only 47%; the corresponding figures for use of helmets, against drink–driving and for use of child restraints are 45%, 33% and 71%, respectively. Much can be gained from improving the safety of vehicles, improving road infrastructure and promoting sustainable, physically active forms of mobility as alternatives to car use. Concerted policy efforts with safe systems approaches are needed to protect all road users in the Region.