Introduction: The aim of this study was to evaluate motorcyclists’ attitudes and performance in relation to high-risk and safe behaviors and their relationship with maxillofacial injuries in Isfahan, Iran in 2011.Materials and Methods: This study was conducted on 385 motorcyclists randomly selected from 5 high-traffic circuses in Isfahan. Data were collected through interviews and included background factors, history of accidents and injuries, motorcyclists’ attitude toward crash helmets and motorcycling risks, and breaking traffic rules. Data were analyzed with SPSS 11.5, using descriptive statistics and chi-squared test.Results: The motorcyclists had positive attitudes toward the factors evaluated; however, such attitudes had no effect on reducing accidents and injuries and increasing use of crash helmets. Only 22% of the subjects reported regular use of crash helmets. Older motorcyclists, married ones, those who had children, and those with lower rate of traffic offences reported greater use of crash helmets (p value<0.005). Seeing someone involved in an accident, causing head injury, was the most important motivational factor for motorcyclists to start using crash helmets, whereas heat, poor ventilation, and limited visibility were the most important factors for not wearing crash helmets. Generally, motorcyclists who reported more traffic violations had more accidents and maxillofacial traumas.Conclusion: Despite positive attitudes, only a small number of motorcyclists use helmets. It is necessary to evaluate motivational factors involved in the use of crash helmets and negative factors precluding their use to promote health and safety.