Study Objective: To describe the extent, nature, and severity of facial injuries among motorcyclists injured in a crash requiring hospital treatment. Methods: The study population consisted of 5,790 motorcycle riders who sustained a nonfatal crash injury during 1991, 1992, or 1993 in 10 California counties. The injured riders were identified in 28 hospitals during 1991 and 1992 and in 18 of these 28 hospitals in 1993. Information was collected from crash reports and hospital records. All injuries were coded according to the 1990 Abbreviated Injury Scale. Results: Facial injury was present in 24.3% of injured riders, a high proportion of them young men. Among riders wearing helmets, 36.8% had facial injuries, compared with 53.8% of those not wearing helmets. Soft tissue injuries and facial fractures were present in 72% and 22% of the injured, respectively. The maxilla (22%), orbit (16%), and nasal (16%) bones were the most frequently fractured facial bones. The frequency of multiple facial injuries, severity of facial injuries, and incidence of high-severity facial fractures was greater among nonhelmeted riders compared with helmeted riders. Upper facial fractures were more common among riders without helmets compared with those wearing helmets. Conclusion: This study provides evidence of the protective value of helmets to reduce risk of facial injury. Information on the positive effect of facial injury sparing provided by helmet use should be incorporated into helmet promotion programs. [Gopalakrishna G, Peek-Asa C, Kraus JF: Epidemiologic features of facial injuries among motorcyclists. Ann Emerg Med October 1998;32:425-430.]