Background Properly used child restraints have been shown to reduce serious death and road traffic injuries to children under 5 years by 80 to 90%. Yet such use remains low around the world. In Qatar, a high-income developing country, child restraint use is not mandated by law even though road traffic injuries are a leading cause of death for 0–5 year olds. This study aimed to assess the extent of child restraint use, among children under 5 years, in Qatar.

Methods A roadside observational study was conducted outside of 9 nurseries and 3 shopping malls in Qatar. Trained observers observed vehicles over a 10- day period and completed 240 hours of observations collecting data on estimated age of child, restraint use and type at nursery and mall entrances.

Results 2,232 vehicle observations were captured from May-June 2015. Over half of all children were either unrestrained (38%) or restrained improperly (21%). Only 27% of vehicle drivers were unrestrained or improperly restrained. For children less than 5 years old and seated in a rear seat, 28% were unrestrained while 8% were improperly wearing an adult seatbelt. Eleven percent of children were incorrectly located in the front passenger seat, unrestrained and/or on an adult’s lap.

Conclusions Child restraint use among under-5s is low in Qatar even while the majority of adult drivers use seatbelts. Given that road traffic injuries are a leading cause of death for children aged 0–5 in Qatar, efforts should be focused on increasing their appropriate use. As a high-income country where much of the population with children is able to afford restraints, interventions should be developed to increase child passenger safety. This should include the enforcement of the current law banning children under 10 years from riding in the front seat, the passage and enforcement of a national law mandating child restraint use, and educational campaigns to increase parental awareness of the benefits of child restraints.