This study was designed to investigate the relationship between upper extremity (UE) injuries and occupant restraint systems among front seat occupants who were involved in frontal motor vehicle collisions (MVCs). Case-control. The 1995 through 2002 National Automotive Sampling System (NASS) Crashworthiness Data System (CDS). Subjects were identified from the NASS-CDS. All cases sustained an UE injury with a ≥2 Abbreviated Injury Scale Score. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated comparing risk of UE in 3 mutually exclusive restraint system groups (seatbelt-only, airbag-only, seatbelt-airbag-combined) to the unrestrained group. Data analysis was adjusted for significant occupant, vehicle, and collision characteristics. Seatbelt-only occupants had a reduced UE injury risk (OR, 0.41; 95% CI, 0.22-0.76). Near null associations were found for airbag-only (OR, 1.1; 95% CI, 0.68-1.76) and seatbelt-airbag-combined (OR, 0.97; 95% CI, 0.56-1.69). The results of this study suggest that UE injuries may become more common as a result of MVCs as the proportion of airbags in motor vehicles increases. © 2005 Lippincott Williams & Wilkins, Inc.