There are approximately 4.2 million tractors on farms and ranches across the United States. The average age of tractors is over 25 years and some of the oldest models are the most popular. Older tractors are less safe than newer tractors, and many older tractors are operated by individuals with increased risk of being injured or killed on a tractor. A key tractor safety device, a rollover protective structure (ROPS), is missing from most tractors manufactured before 1985. Data from the US Department of Labor's Census of Fatal Occupational Injuries (CFOI) suggest that the production agriculture sector accounts for approximately 70.3% of the 3299 work deaths in the Agriculture, Forestry, and Fishing industry between 2003 and 2007. Nearly 900 of these incidents involve farm tractors and of these, approximately 43% were from tractor overturns. Efforts to reduce both the number of tractor overturn fatalities and injuries have been underway for years. These efforts primarily encompass worker education/training programs and activities, ROPS design and engineering applications, and research on more effective ways of encouraging tractor owners to retrofit their older tractors with ROPS. This paper reviews various approaches available to reduce the fatalities, serious injuries, and economic burden associated with tractor overturns. Past and current efforts to promote ROPS in the United States and in other countries, current safe tractor operations education and training programs, and ROPS-related safety engineering projects are discussed. Recommendations for advancing safe tractor operation and the number of tractors protected by ROPS are given. This review was prepared for the Agricultural Safety and Health Council of America/National Institute for Occupational Safety and Health conference, "Be Safe, Be Profitable: Protecting Workers in Agriculture," January 2010.