Low risk perception and high impulsivity, in conjunction with substance abuse disorders, are associated with the occurrence of injury in the general population. The study described in this article investigated the association of risk perception and impulsivity with risky behaviors (infrequent seat belt use, drinking and driving, riding with a drunk driver, binge drinking, and speeding for the thrill) among adults with unintentional blunt trauma. Patients (N = 756) were assessed for substance abuse disorders and participation in risky behaviors. Risk perception and impulsivity were measured by questionnaire. Pearson's chi-square statistic was used to investigate risk perception, impulsivity, substance abuse, and possible confounders relative to risky behaviors. Odds ratios were calculated using logistic regression methodology. Univariate results indicated that low risk perception and high impulsivity were significant risk factors for risky behaviors. After adjustment for confounding factors, low risk perception and high impulsivity remained significantly associated with risky behaviors in the trauma patient population.