Background Road Traffic Injury (RTI) is the burden and serious problem, especially in Thailand, it is the major problem. The policy of helmet use was established for many years, but the proportion of helmet use is still unsatisfied. We would like to show that how do the helmet use impact in term of outcome and motivate our patients to use it, as well.

Methods Cross sectional study and data were extracted from trauma registry system of Khon Kaen Hospital (KKH). We enrolled motorcycle accident patients who visited or/and admitted to our hospital between January 2014 to December 2014. We use Chi-square and Fisher exact test for analysis data.

Results Overall we enrolled 2,473 eligible patients. Of these, helmet used patients were 11.85% (293). Low Glasgow Coma Scale (GCS) [OR (odds ratio), 6.39; 95%, CI: (confidence interval), 3.63–11.24; p < 0.0001], High Abbreviated Injury Scale (AIS) [OR, 3.63; 95%, CI: 2.50–5.27; p < 0.0001], and mortality rate [OR, 10.06; 95%, CI: 2.47–40.84; p < 0.0001] were associated with non-helmet used patients. Over all mortality rate was 5.78%

Conclusions This study was shown strongly impact of the benefit in helmet used motorcycle accident patients. Obviously, it was able to reduce severity of injury and mortality rate, but there was still low proportion of helmet use in these patients. The helmet use policy should be emphasised and encouraged by the Government more and more.