Chance Fractures are transverse fractures of the spine and have been most frequently seen following motor vehicle crashes in which the patient was restrained only by a lap belt. After the advent of three-point restraint systems, the incidence of Chance Fractures among restrained car passengers decreased. We present here a typical case of Chance Fracture that was accompanied by superior mesenteric artery bleeding. It involved a 31-year-old female passenger who was improperly using a three-point restraint system. This is accompanied by a review of the current literature on the topic. Emergency physicians must consider this type of seat beltrelated injury when initially evaluating any patient involved in a motor vehicle crash who was restrained by a vehicle seatbelt.