Background: Although mandatory helmet laws exist in many countries, compliance has been reported to be poor in some countries in Sub-Saharan Africa. The success of programs aimed at increasing the use of helmets by motorcyclists depends on the identification of the factors associated with helmet usage. Sociodemographic factors have been reported to differ between motorcyclists who consistently wear a helmet and those who do not. The identification of the factors associated with helmet usage would enable the institution of targeted measures to enhance compliance with mandatory helmet laws.Methods: The study examined factors associated with wearing helmets by motorcyclists to inform policies geared towards reducing the burden of motorcycle-related road traffic crashes. This analytical cross-sectional study was conducted at the 37 Military Hospital, Accra, Ghana. Demographic data of patients presenting with maxillofacial injuries secondary to motorcycle crashes were consecutively collected and analyzed. The use of a helmet was compared among sex, age category, occupation, and patient role. Statistical significance was inferred at an alpha level of 0.05.Results: There was no statistically significant difference in the use of helmet by male and female motorcyclists. (P=0.537). Middle-aged adults were more likely to wear a helmet as compared with young adults and minors. (P=0.043). Also, 62% of formally employed participants wore helmets, while a disparate 46% and 30% of informally employed and unemployed participants wore helmets at the time of injury. The difference was statistically significant (P=0.019), likewise the comparison of helmet wearing between riders and pillion passengers (P=0.002).Conclusion: The use of helmets by motorcyclists is associated with age, occupation, and role of the motorcyclists. The implementation of mandatory helmet laws needs to consider the attitude of particular population groups to ensure its success.