Objective: In 2010, motor vehicle crashes were the leading cause of death among 13 – 19 year-old males and females in the United States (National Center for Injury Prevention and Control, 2014). The overall goal of this research is to differentiate between measures associated with crashes for young teen drivers, age fourteen to fifteen years on urban and rural roads. Methods: A retrospective study of motor vehicle crashes among 14 and 15-year old drivers in the state of Iowa was conducted using crash information obtained from the Iowa Department of Transportation for the years of 2001 to 2013. Crash rates were calculated by rurality using Urban Influence Codes (UIC). The total number of crashes and crashes resulting in injury were divided by the population of young teen drivers aggregated at the UIC level. Crash and driver characteristics were analyzed for measures of association to the main outcome, injury using logistic regression. Crash and driver characteristics that were associated with injury at the p ≤ 0.20 level were eligible for model inclusion. Results: For every 1,000 young teen drivers age fourteen to fifteen years, nearly 8 were involved in a crash statewide from 2001 - 2013. Half of all crashes in the dataset occurred in an urban area (n = 4327, 51%), while 7% occurred in a suburban area, 29% in a town and 13% in a remote rural area. Results show, for all crashes and crashes resulting in injury, that as the level of rurality increases, rates of crash also increase. Remote rural crashes have the highest crash rate ratio (RR = 1.15, 95% CI: 1.08, 1.22), relative to urban crashes. The presence of multiple teen passengers in the vehicle increased the odds of having a crash that resulted in injury 10.73 times, compared to no passengers being present (95% CI: 7.10, 16.22). Characteristics with the strongest association with injury were single vehicle collisions, crashes that occurred on rural roads, crashes were the driver lost control and crashes were multiple teen passengers were present. Conclusions: Results from this study highlight the dangerous circumstances that young teen drivers face, especially when driving on rural roads. In order to protect young teen drivers from crashes, there is a need for more restrictions on the number of passengers and the development of prevention methods to make young teen drivers safer.