Background Child safety restrains are known as the most effective measures in protecting children from severe injuries and death while travelling in a car. Little is known about the Romanian rates of child safety restrains as the legal requirements are new and there is little enforcement.

Methods An observational study on child safety restraint use was conducted in Cluj-Napoca, Romania, between 2013 and 2014. Child restraint and parent surveys were conducted at 38 schools and kindergartens and 3 commercial areas, to explore the use of safety restraints. Drivers were asked about their knowledge and attitudes towards restraint legislation and safety behaviour. A total of 892 children were observed and 533 (69.4%) drivers approached responded to our survey.

Results Of the total number of observed children, 67.4% were travelling in some type of restraint. One third of the children were registered as being properly fitted (38.3%). More than two thirds of the drivers approached (n = 348, 68.4%) had knowledge about the existence of child safety restraint legislation. Among parents who did not use a child safety restraint, low use was attributed to lack of awareness and knowledge (49.4%) followed by being aware but choosing not to (27.9%), financial reasons (12.7%) and the seat being in the other car (10.1%). They were also asked to give examples of what would motivate them to use child restraints for their children and 26.6% indicated that a better law would increase the use, while 11.4% acknowledged that free availability will determine them to use restraints.

Conclusions Parent drivers could benefit from proper knowledge on the importance of and how to correctly use child safety restraints, as few children were properly restraint in our sample population. The majority of parents had some information on child safety restraint use and were aware that they are important, yet a large proportion of parents were not using restraints, therefore raising awareness actions are much needed.