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<p>Abstract</p> <p>Background</p> <p>This study sought to understand the factors associated with street racing among the illegal motorcycle racers in Malaysia or known as the <it>"Mat Rempit"</it>.</p> <p>Methods</p> <p>Street outreach interviewer-administered surveys were conducted from June 2008 to January 2009 in this multi-state study.</p> <p>Results</p> <p>A total of 2022 participants were surveyed, the mean ± <it>SD </it>age of the participants was 20.5 ± 3.4 years (age range: 12 to 35 years). Mean duration of street racing was 2.65(<it>SD </it>± 1.77) years (range: 2 months to 12 years), with 50.1% and 35.8% reporting stunt riding and alcohol drinking while racing, respectively. With regard to risk behaviours, cigarette smoking was highly prevalent among the study participants (78.3%), followed by alcohol drinking (27.8%) and recreational drug use (18.8%). Participants scored high on the masculinity scale (15.7 ± 4.0 out of 21.0). The results of the logistic regression analysis showed that socio-demographic variables, risk behaviour and masculinity scores were associated with racing frequency.</p> <p>Conclusion</p> <p>Given these associations, tailoring family-centered interventions to the needs of the lower socio-economic groups and interventions recognizing the negative consequences of health risk behaviours related to street racing as an expression of traditional masculinity should be emphasized.</p>