Background Like many other low and middle income countries, motorcyclist has been increasing significantly in Bangladesh. However, the information regarding the helmet use by motorcyclists is very scarce.

Objective The objective of this study was to estimate the prevalence of helmet use and to determine the factors that influence the non-compliance in helmet use among the motorcyclist in Bangladesh.

Methods 300 motorcyclists were selected randomly from the three areas of Bangladesh-100 from capital city Dhaka, 100 from a district town Mymensingh and 100 from rural community Gouripur. Data were collected from motor cyclist at fuel station using a pretested structured questionnaire.

Results All the respondents were male with a mean age of 32.8 years (±8.1). The point prevalence of helmet use was 45.3%, however only 53% of them were regular safety helmet users. A significant risk of non-compliance in helmet use was observed among young aged (20–24 years) motorcyclist (OR 17.6, 95% CI 4.3 to 71.1) compared to motorcyclists aged 45 years and above. Significant association was also found between unmarried motorcyclists (OR 5.3, 95% CI 2.8 to 5.2) and non-compliance in helmet use. The non-compliance in helmet use among rural motorcyclist was 13 times higher than motorcyclists of metropolitan city.

Significance The study revealed that unmarried youth motorcyclists of rural areas of Bangladesh are non-compliant in helmet use. This information will help policy makers to design effective road safety measure to increase the helmet use by motorcyclist which ultimately will reduce the mortality and disability from motorcycle accidents.