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Road traffic injuries are a major public health problem for the 21th century. About 1.3 million people lost their lives each year because of road traffic crashes, with millions more sustaining serious injuries and living with long-term adverse health consequences. 90% of road traffic deaths occur in low- and middle-income countries although they account for 82% of the world's population with only 54% of the world's registered vehicles. Proper seat belt wearing can significantly save lives and reduce the risk of serious injury during road traffic crashes. Currently, in Ethiopia, an increasing vehicle crash fatalities and injuries is one of health challenges though it has road traffic laws including seat belt use since 2011.Commercial public transport vehicles, especially taxi/mini buses and public transport buses usually prone to traffic crashes. Although the well known drivers' seat belt use estimate and enforcement seem to be high, Ethiopia has no proper seat belt utilization estimate and enforcement. Reliable estimate and enforcement of proper seat belt usage is confirmed by an in-side vehicle observation aimed at reducing the burden of traffic severe injuries and fatalities.