The focus of this study is roadway safety in American Indian reservations. We provide new sources of data and policy- relevant findings to address the unusually high rates of roadway fatalities and injuries among American Indians. Qualitative methods were used to generate and analyze data from people with the most direct knowledge of and responsibility for reservation roadway safety. Four case studies were conducted in partnership with the tribal governments of the Red Lake, Fond du Lac, Leech Lake, and Mille Lacs reservations; these data sources include fieldwork (90 days), interviews (n=102), focus groups (n=8), and short surveys (n=220). These data are triangulated with data from FHWAís 2016 nationwide survey of tribes and states (n=196). Key findings from this extensive data analysis are: 1. Pedestrian safety is a critical, yet under-recognized issue on reservations. This is unequivocal across all data sources and differentiates reservations from rural areas in general. 2. Reservation road engineering and repair are very high priorities according to both tribe and state governments. 3. Reckless driving is a multi-faceted concern, including not only impaired driving but also cell phone distraction and speeding. 4. Education and enforcement to increase seatbelt and car seat use are named as high priorities in the national survey. 5. Tribes need better cooperation with local, state, and federal agencies. Priorities include addressing data quality and sharing issues better inter-jurisdictional cooperation for infrastructure and enforcement. The study concludes with recommendations to improve roadway safety in reservations and for further research.