Despite the fact that bicycle helmet usage reduces the risk of bicycle-related head injuries, only a small percentage of children routinely wear helmets. The aim of this study was to qualitatively explore the barriers to bicycle helmet usage among 12 and 13 year old children. The study is based on four focus groups with 31 children from schools is an urban New York City area. A majority of both boys and girls did not perceive a need for wearing helmets for routine riding or short trips, and felt that helmet usage was uncomfortable and made them appear dumb. Also, students could not recall any health promotion efforts by a variety of health providers and felt local legislation had little impact on usage rates. The qualitative findings of this study provide valuable material for researchers seeking to understand the factors associated with non-use of bicycle helmets.