Objective  To examine car passenger safety behaviors and its associates among preschool children in a district of Beijing.

  Methods  Using stratified cluster sampling and a self-designed questionnaire, we conducted an online anonymous survey among parents of 3 264 children aged 3 – 6 years recruited from 6 kindergartens in a district of Beijing during 27 – 31 December 2021.

  Results  Of the 3 134 participants (96.29% of the parents recruited) with eligible responses, 38.56% reported using child safety seats for their kids in cars, followed by 31.88% and 21.16% reporting seat belt use and holding the kids in arms by caregivers while driving; taking no safety precautions at all was reported by 8.40% of the participants. Higher rates of child safety seat use were reported by parents of only children (43.75% vs. 34.05%), who were aware of child safety seat legislation (47.66% vs. 20.88%), had correct knowledge of child car passenger safety (47.58% vs. 28.54%), and always buckled up while driving contrasted with those reported by parents of two or more children, who were unaware of child safety seat legislation, had misconceptions about child car passenger safety, and did not always wear seat belt. Multivariate logistic regression analysis following promoting factors for the parents' child car passenger safety practices: having an only child (odds ratio OR = 1.376), with an annual household income 240 000 Chinese yuan and more (OR = 1.368), being aware of safety seat legislation (OR = 3.325), with correct knowledge of child car passenger safety (OR = 1.991), and always wearing seat belt while driving (OR = 5.231).

  Conclusion  Child car passenger safety practice is at a relatively low level and influenced by parental demographic and economic status, awareness of knowledge about child car passenger safety, and safety driving behavior among the parents of preschool children in a district of Beijing, suggesting that relevant targeted interventions need to be promoted among the parents.