Three unusual injuries of the cervical spine in wearers of three-point seat belts are reported. In two cases, the presence of bruising under the chin indicated their involvement in the mechanism of the injury. In the remaining one case, a seat belt might have been related to the injury because there was no other complication. The pattern of spinal injury and neck bruising suggest that the responsible flexion force was enhanced in some way by seat belt fixation at the mid-cervical region. We suggest that neck bruising should arouse suspicion of cervical spinal trauma.