Aims & Objectives: Road crashes are the leading killer of children and youth aged 5–29 years. Uneven regulations and low safety awareness challenge child motorcycle riding in Latin America (LATAM). We examined motorcycle riding and helmet use among children under 18 in LATAM, focusing on factors influencing correct helmet use (CHU). Methods: We examined Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS) data across 13 LATAM cities from 2020 to 2023. Descriptive statistics were employed to characterize children riding motorcycles. We used a multilevel logistic regression in Stata 18 to explain CHU based on individual-level predictors, accounting for random effects at the country and city levels. Results: Of 343,915 individuals, 857 were drivers < 18 years old (63% CHU). Passengers: < 5: 277 (15% CHU), aged 5 to 11: 799 (CHU 33%), aged 12 to 17: 1,164 (CHU 61%). Passengers showed lower odds of CHU compared to drivers < 18: < 5 OR: 0.24, 5 to 11s OR: 0.64, 12 to 17s OR: 0.79. This trend persisted when comparing only child passengers, with increased CHU odds with age: ages 5-11 (OR: 2.59) and 12-17 (OR: 3.24). Child passengers showed lower helmet use on local roads than on arterial roads, OR: 0.62. Intra-country correlation can explain 13% of the variability in CHU, while 30% is due to correlation in cities within the same country.Conclusions: Disparities in helmet use among child riders in LATAM highlight the critical role of age and road type, emphasizing the need to regulate safety measures at local level. Keywords: pediatric trauma, injuries, road safety, road traffic injuries