National seatbelt observation surveys indicate commercial vehicle drivers' seatbelt usage is lower than passenger vehicle drivers. Seatbelts are effective at preventing injuries and death following motor vehicle crashes and an important component in decreasing morbidity and mortality related to commercial vehicle crashes. We conducted an observation survey of heavy commercial vehicle drivers' seatbelt usage to gather baseline data and to aid in planning prevention programs. We found that the observed heavy commercial vehicle drivers had a seatbelt usage rate of 64%, approximately 20% lower than the national rate for drivers of passenger vehicles. Our observations demonstrate a need to increase seatbelt usage among heavy commercial vehicle drivers. Specific programs and resources for intervention programs targeting heavy commercial vehicle drivers are warranted.