PURPOSE: To compare injury sustained and severity of child occupant according to the types of safety restraint systems in motor vehicle crashes. METHODS: This was a retrospective observational study. The study subjects were child occupants under the age of 8 years who visited a local emergency center following a motor vehicle crash from 2010 to 2014. According to safety restraint: child restraint systems (CRS), belted, and unbelted, we compared injuries sustained and injury severity using the maximal Abbreviated Injury Scale (MAIS) and Injury Severity Score (ISS), and analyzed the characteristics of severe injuries (AIS2+). RESULTS: Among 241 subjects, 9.1% were restrained in CRS, 14.5% were only belted, and 76.3% was unbelted at the time of the crashes. Fourteen had severe injuries (AIS2+), all of whom didn't be restrained by CRS. Injuries in face and neck were the highest in unbelted group, and MAIS and ISS were the lowest in CRS group. CONCLUSION: Among safety restraint systems for child occupant in motor vehicle crashes, the CRS have the preventive effect of face and neck injuries, and are the most effective safety restraint systems.