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To date, efforts to improve occupant protection in side impact crashes have concentrated on reducing the injuries to occupants seated on the struck side of the vehicle arising from contact with the intruding side structure and/or external objects. Crash investigations indicate that occupants on the struck side of a vehicle may also be injured by contact with an adjacent occupant in the same seating row. Anecdotal information suggests that the injury consequences of occupant-to-occupant impacts can be severe, and sometimes life threatening. Occupant-to-occupant impacts leave little evidence in the vehicle, and hence these impacts can be difficult for crash investigators to detect and may be underreported. The objective of this study was to evaluate the risk of impact injury from occupant-to-occupant impacts in side impact vehicle crashes. The study examined 9608 crashes extracted from NASS/CDS 1993-2006 to investigate the risk of occupant-to-occupant impacts.