The purpose of this article is to help surgeons understand and anticipate the pattern of injury, and biomechanics of the seat belt syndrome (SBS), better assess trauma patient and identify a patient who is more likely to have an underlying issue, caused by improper use of the seatbelt.We present a case of SBS occurring in a patient with a high BMI and an improper relaxed position, in context by a frontal car impact. The purpose is to use an example to describe the dynamic between the car occupant and the vehicle in case of a high-speed collision and what type of injury to expect.