National injury surveillance systems, trauma registries, and death certificates lack sufficient detail to distinguish car-surfing victims from others who have fallen from a moving motor vehicle. For example, the National Electronic Injury Surveillance System-All Injury Program, which uses data from emergency department records, does not contain sufficient detail to distinguish car-surfing cases effectively. Among factors that might account for this absence of distinguishing information are a lack of awareness of this activity among health-care professionals and the difficulty of capturing the intent of a person riding on top of a moving vehicle. Another issue is the lack of coding options to describe this particular behavior precisely. For example, although e-codes are typically used to capture cause of injury in traditional public health data sets, the closest e-code, 818.8, is too broad in definition to specifically capture car-surfing cases and does not define the intent of the person who was injured.4 Therefore, to obtain an approximate characterization of car-surfing injuries and deaths, CDC identified probable car-surfing incidents from an August 2008 LexisNexis* search of U.S. newspapers, using the terms “car surfing,” and “injury” or “death.” A case was defined as an injury of a person that resulted from the person intentionally riding on the exterior of a motor vehicle while it was being driven by another person. Resulting injury could come from falling off the moving vehicle, falling down onto the vehicle, jumping from the vehicle, or being hit by an object while on top of the moving vehicle. Persons who had placed themselves on a stationary vehicle, and did not intend to remain on the vehicle once it began to move, were excluded. Identifying information was used to avoid counting the same event more than once if it was reported in multiple newspapers or repeatedly by the same newspaper.