States With the Most Fatalities Regardless of Vehicle Inspection Requirements (2019-2023)

This table shows the top 24 states ranked by fatality rate per 100,000 people, regardless of vehicle inspection rules. South Carolina, with no inspection requirements, tops the list at 1.79. West Virginia follows in second place at 1.51 with biennial inspections, and Maryland comes third at 1.55, requiring only a one-time inspection after purchase.