The objective of this study was to identify risk factors related to the driver, the vehicle and the environment, that are associated with motor vehicles accidents on highways. A case and control design was used where the case was: the driver of a motor vehicle who was involved in an accident while traveling on the Mexico-Cuernavaca highway; and the control was: the driver or a motor vehicle who, traveling on the highway, completed the trip without being involved in a traffic accident. Risk factors associated with the occurrence of a traffic accident (P > 0.05) were: age under 25 years, frequent travel, traveling to work, alcohol consumption, driving during the daylight, on a week-day, under adverse weather conditions and in the Mexico Cuernavaca direction of road. Risks adjusted by logistic regression were: age under 25 years odds ratio (OR) 3.01, confidence interval (CI) (95%) 1.46-6.18; work as a travel reason OR 1.74, CI 1.06 2.86; alcohol intake OR 4.70, Cl 1.62 13.6; driving under adverse weather conditions OR 5.70, CI 3.66-8.85; traveling on a week-day OR 1.84, CI 1.14-2.94; during daylight hours OR 4.23, CI 2.36-7.58 and in the Mexico Cuernavaca direction of road OR 2.69, CI 1.67 4.32. The identification of factors associated with the risk of being involved in a highway traffic accident allows us to propose primary prevention measures for this important public health problem.