Side impact motor vehicle collisions (MVCs) are associated with higher morbidity and mortality compared with other types of MVCs. The stiffness of the lateral aspect of the vehicle and restraint use may play a role. The purpose of this study was to evaluate the role of restraint use, vehicle size, and compartment intrusion on the incidence of splenic injury in side impact MVCs. © 2001 Lippincott Williams & Wilkins, Inc.