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PurposeThis paper analyzes the impact of obesity on the probability of a motor vehicle fatality (highway death rate) and on its component probabilities: the probability of a fatality, given a crash (vulnerability rate) and the probability of a crash (crash rate).Design/methodology/approachUsing state-level data for 1995–2015, the paper estimates models explaining all three rates. Explanatory factors include obesity and a representative set of potential determinants.FindingsResults indicate that obesity has a statistically significant positive relationship with the highway death rate and the crash rate. Also having a statistically significant positive association with at least one of the three rates are the proportions of young and old drivers, alcohol consumption, the ratio of rural to urban vehicle miles and temperature. Factors with a statistically significant negative relationship with at least one of the rates include primary seat belt laws and precipitation. In 2016, a total of 928 traffic fatalities could have been avoided if obesity rates decreased by one percentage point.Practical implicationsSeat belts and crash dummies should be better designed to fit and represent those with higher BMIs, and education efforts to increase seat belt use should be supplemented with information about the adverse impact of obesity on highway safety.Originality/valueThis paper uses 21 years of state-level information, including socio-economic and regulation data, and contributes to the existing research on the relationship between obesity and highway safety.