Research on motor vehicle safety has involved virtually all modes of transportation. Most of these have been national in scope with relatively few studies focused on the determinants of motor vehicle fatalities at the state level. This paper investigates the determinants of motor vehicle fatalities across the states of California, Illinois, Louisiana, Pennsylvania, and Texas which collectively account for 27% of U.S. motor vehicle fatalities in 2006. A major conclusion is that fatalities and its determinants vary by state, and several of these determinants are subject to state policy control. As such, our coefficient estimates and econometric framework are relevant for designing policies intended to reduce motor vehicle fatalities.