Motor vehicle crashes remain a leading cause of death for children worldwide, despite the proven effectiveness of child restraint systems (CRSs). This review article highlights persistent challenges, including high rates of misuse, socioeconomic disparities, and evolving risks from ride-share and emerging vehicle technologies. It underscores the critical need for legislation, education, equitable access to CRSs, and clinician advocacy to promote proper restraint use. Coordinated efforts among health care providers, policymakers, and community organizations are essential to eliminate preventable injuries and fatalities ensuring that every child is safely restrained on every trip.