Background Child passenger safety is an important initiative in hospitals across the country. State laws require that parents and caregivers secure a child into a car seat from birth through the age of eight or until they reach 4’9” in height. Car seats have an expiration date and any car seat that is involved in a moderate or significant motor vehicle crash should be replaced and yet, many parents resort to storing old car seats. Here, we sought to determine the barriers and facilitators to the establishment of car seat recycling programs as part of the injury prevention programs at American College of Surgeons (ACS) Level I Pediatric Trauma Centers. Methods Semi-structured phone interviews were conducted with Injury Prevention Coordinators at 58 ACS Level I pediatric trauma centers. Phone interviews were conducted over an 8-week period and 3 attempts were made to contact an Injury Prevention Coordinator at each center. Both closed and open-ended questions were asked to elicit descriptive and categorical responses. Questions detailed interest in starting a program, inquired about funding, staffing, administrative support, and also sought to gauge community interest. Results Of the interviewed injury prevention programs, only two hospitals had active car seat recycling initiatives. The two programs recycled between 100-500 car seats yearly. The two programs attributed their success to a partnership with in-house hospital recycling, eliminating the need for funding and claimed their recycling bin visibility monthly at the door of the hospital helps with informal advertising, and partnership with a third-party recycling company with education and advertising schemes, respectively. Of the hospitals without a car seat recycling program, almost 70% were interested in either starting or re-starting a program. A common impediment to starting a program was a lack of recycling company partnerships that accept the foam, straps, metal, and type of plastic used in car seats. Additionally, insufficient program staffing, funding, and storage of collected car seats were other major barriers for car seat recycling program. Discussion Our results revealed that whether or not a recycling program was in place, a community need for options to dispose of car seats exists nationwide. ACS Level 1 Pediatric Trauma Centers can play a pivotal role in addressing community need. It was also evident that an in-hospital or nearby third-party recycler, sufficient staff to strip car seats, and funding for car seat storage and transportation are necessary for a cost-effective recycling program. Moreover, successful car seat recycling programs are a possibility with either in-house hospital recycling or third-party partnerships and that it could serve as an important avenue for child passenger safety education and outreach.