Over the past four decades, motorcycle helmet laws within the United States have been in a state of flux and have been shaped by the conflicting influences of the federal government's initiatives to shape state policies and motorcycle advocates' persistent lobbying efforts. Examination of individual state experiences with motorcycle helmet legislation demonstrates that universal motorcycle helmet laws effectively promote helmet use compliance, reduce morbidity and mortality in motorcycle crashes, and lower the health care costs and associated societal burdens of these crash victims. Motorcycle advocates have challenged the implementation of these laws and directly influenced the weakening or frank repeal of these laws to negative consequence. We offer this review as an educational resource to encourage and facilitate health care worker participation in legislative efforts to support implementation and maintenance of universal motorcycle helmet laws.