In response to tire failures and vehicle rollover accidents, most notably those experienced by Ford Explorers with Firestone Tires, the 106th Congress and President Clinton enacted the Transportation Recall Enhancement, Accountability, and Documentation (TREAD) Act of 2000. Section 13 of the TREAD Act requires vehicle manufacturers to install tire pressure monitoring systems (TPMS) that alert drivers when a tire is significantly under-inflated. This paper first discusses the political economy that ultimately led to the final TREAD Act TPMS regulation. Then, relying on the variation of model-year TPMS introduction, I investigate whether and to what extent TPMS reduces all vehicle fatalities and those associated with tire failure and improper inflation. I find that the introduction of TPMS is associated with just over 11 fewer tire failure-related deaths per year, resulting in a net benefit of −$752 million to −$1,876 million (in $2001) per year. I find no change in the number of tire inflation-related fatalities with the introduction of TPMS.