Introduction The management of seatbelt-related abdominal aortic injuries is not well established. This study analyses the clinical characteristics, management, and outcomes of patients with abdominal aortic dissections resulting from seat belt injuries in motor vehicle accidents. Methods A retrospective analysis was conducted on five patients diagnosed with seat belt-related abdominal aortic dissections between 2022 and 2023. These patients were identified through admission CT trauma series. Results The average age of the patients was 34.8 (SD 16.4) years, with a range of 19 to 59 years. The cohort included two males and three females. All injuries resulted from motor vehicle accidents, with four head-on collisions and one T-bone collision. The average speed at the time of the accidents was 80 km/h. All patients were restrained with seat belts; three were drivers, and two were front-seat passengers. Associated injuries included solid or hollow visceral injuries in four patients, hypovolemic shock in three patients, and vertebral fractures in three patients. The presence of a seatbelt sign was noted in four patients. The average hospital length of stay was 51 days (range 10 -206 days). There was a similar length of stay between operative (n=1) and non-operative (n=4) cases (p= 0.669). Management strategies varied. Four patients received non-operative treatment, one patient underwent covered endovascular reconstruction of the aortic bifurcation. Surveillance imaging was performed within 24 hours for three cases, at 48 hours for one case, and at seven days for one case. All patients achieved stable outcomes. Conclusion Seat belt-related abdominal aortic dissections in motor vehicle accidents present a significant clinical challenge. The findings indicate that both operative and non-operative management can result in stable patient outcomes. Further research with larger sample sizes is necessary to validate these results and refine treatment protocols for this specific injury.