Motorcyclists are over-represented in casualty crashes in Malaysia, accounting for approximately 60 percent of all road fatalities. In order to develop effective ways to reduce motorcyclist casualty crashes, it is important to identify the extent of the problem, critical safety issues, the types of crashes that present the greatest risk to riders, and the factors commonly associated with these crashes and their causal factors. The objective of this paper was to explore current crash and injury factors for motorcyclist fatal collisions in Malaysia. Fatal motorcycle crashes occurring between 2007 and 2011 were extracted from the crash database to examine crash and injury patterns, including collision type and location, road geometry, vehicles involved, number of people involved, driver/rider error, demographic characteristics of riders, and injury outcomes. The results identified a number of key collision and rider characteristics that were associated with motorcyclist injury, including riding on rural federal and state roads, and intersections in urban environments, speeding, not wearing a helmet, and being young and a male. Children and young adults were also at risk of injury as pillion passengers. These findings have significant implications for countermeasures to address priority motorcyclist trauma issues in Malaysia including improved road design, speeds, as well as supporting educational and enforcement initiatives.