Since enactment of the Kentucky child restraint law in 1982, the number of motor-vehicle-occupant deaths among children aged 0-4 years has decreased 37%. A substantial proportion of this decline is attributed to the increased use of child safety seats (CSSs); in 1995, use of CSSs in Kentucky was 72%. In 1996 in the United States, although approximately 85% of infants and 60% of children aged 0-4 years were restrained, approximately 80% of CSSs were used improperly. The effectiveness of CSSs in preventing death and injury is reduced when they are used incorrectly. To estimate the rate for improper use of CSSs, the Kentucky Injury Prevention and Research Center analyzed data from observations and inspections of vehicles entering the main community shopping center parking lot during 1 day in each of two rural counties. This report summarizes the results of this study, which indicate that most children in CSSs were restrained improperly.