To evaluate the cost effectiveness of a 4.5 year education campaign that promoted farmers' adoption of rollover protective structures (ROPS) to prevent tractor overturn injuries. Randomized controlled trial, decision analysis, and cost effectiveness analysis. One treatment county and one control county in the State of Kentucky. A campaign by a local tractor and equipment dealership to encourage farmers to purchase and install ROPS and seatbelt retrofit kits for older tractors. Number of injuries averted and cost per injury averted. The dealership's 4.5 year intervention was shown to potentially reduce both fatal (0.26) and non-fatal (1.50) injuries by 2.6% in its county over the intervention period using a 20 year analytic horizon. When extrapolated statewide, 6.7 lives would be saved and 39 non-fatal injuries would be averted over the combined 24.5 year combined intervention period and analytic horizon. The intervention for this period was cost effective with a "savings" of 35,713 dollars per injury (fatal plus non-fatal) averted at a 4% discount rate. Tractor manufacturer promotions can influence their dealerships to promote ROPS retrofits by their customers. A manufacturer backed dealer ROPS retrofit campaign was cost effective in reducing overturn related injuries.