• To identify attitudes toward bicycle helmet ownership and use, questionnaires were sent to parents of 2178 third-graders; 1057 (48.5%) returned valid responses. Of 931 children who had bicycles, 24% owned helmets, but only 56% of children who owned helmets wore them. Helmet ownership, but not use, was associated with higher parental education. Fifty-one percent of 704 parents of bicycle owners who had not purchased helmets said they had never thought of it, 29% thought helmets were too costly, and 20% felt their children would not wear them. Of 792 children who did not wear helmets, 25% said they did not wear them because their friends did not; 22% never thought about wearing helmets; and 16% found them uncomfortable. Efforts to increase the wearing of helmets should address helmet design, awareness, peer pressure, and cost.