Reductions in motor vehicle injury and death represent a major public health success. Since the advent of the federal program in highway safety in 1966, motor vehicle deaths have dropped dramatically, not only in rates per miles driven but also in absolute numbers. Key to this success has been the broad-based comprehensive approach promoted by the program's first administrator, a public health physician. The federal program provided leadership and coordination that leveraged national, state, and local programs to bring about safer vehicles, improved traffic records, more effective enforcement, enormously improved emergency medical services, more responsible judicial systems, and many other accomplishments. Although progress has been made on many fronts, major areas addressed here include federal motor vehicle safety standards, alcohol safety programs, occupant restraint laws and usage, and speed limits. The achievements in motor vehicle safety provide a model for other injury control efforts.