Introduction Despite the importance of helmet in prevention of head injuries in motorcyclists, there is lack of use of helmet both by riders and pillion passengers. It is a common practice in Pakistan that women pillion passengers do not wear helmet. The objective of the study is to assess the knowledge of women pillion riders regarding the motorcycle safety especially use of helmets.

Methods Data were collected from five focus group discussions held with women pillion riders working at the Aga Khan University. The study participants were recruited voluntarily. Written informed consent was taken from each participant before beginning of each discussion.

Results Some major themes emerged from the data analyses, which included (1) motorcycle is a risky transport particularly due to clothing of women that gets trapped in wheels and causes injuries (2) All participants never wore a helmet and never thought about it before, on the contrast, the most important benefit of helmet use expressed was “safety” (3) Main barriers to helmet use, identified were, included: lack of appropriate information on helmet use; unaware of helmet laws; gazes or stares of people; the current sitting style of women in bikes with both the legs on one side (4) Strategies to implement helmet use included; awareness campaigns in media; women should make example and start using helmet as a first step; strict law enforcement in the form of fine/challans.

Conclusion The findings of this study provide insight factors associated with non-use of bicycle helmets.