All-terrain vehicles, originally introduced as utility vehicles to be used on farms or ranches, have now gained immense popularity in the United States as a form of recreational activity. With the increasing popularity of these vehicles, along with more powerful engines, a corresponding increase in the injury and death rates has been noted. We discuss the experience in the emergency department and trauma unit of a Southwest teaching hospital, an area where these vehicles are in use year round. We suggest ways to prevent and minimize accidents to reduce the number of injuries and deaths.