Traffic accidents not only cause injuries and deaths but also result in significant property and economic losses. With annual 40,000 lives lost in United States and $80 billion in economic losses, research in minimizing accidents is a major priority. This research identified and ranked factors that reduce traffic fatalities and determined their relative importance. A total of 93 factors were identified and ranked into seven major categories through a systematic literature review. A questionnaire was sent to the State Departments of Transportation, and the responses were coded and analyzed using a relative importance index, rankings and percentages. The systematic literature review and survey results indicated that agencies should direct resources toward the highest-ranking factors to achieve better safety performance. Efforts should be made to improve infrastructure and influence road-user behavior towards safer habits. Laws and policies are vital to maintaining good road-user behavior, which could leads to lower traffic fatalities.