Introduction. Technological advancements have the potential to enhance people’s quality of life, but their misuse can have a detrimental impact on safety. A notable example is the escalating issue of distracted driving resulting from the use of mobile phones behind the wheel, leading to severe crashes and injuries. Despite these concerns, both drivers’ usage patterns and their risk-related associations remain scarcely documented in Mexico. Therefore, this descriptive study aimed to examine the mobile phone usage of Mexican drivers, its relationships to risk awareness and near-miss/crash involvement, and the self-reported underlying reasons for this behavior. Methods. This cross-sectional study utilized a sample of 1,353 licensed Mexican drivers who took part in a nationwide series of interviews regarding their onboard phone use settings. Results. A significant percentage of drivers (96.8%) recognize using a mobile phone while driving as high-risk behavior. However, only 7.4% reported completely avoiding its use while driving, with 22.4% identified as high-frequency users. Frequency was also found positively associated with the self-reported rate of near-misses and crashes. Furthermore, qualitative data analysis highlights the emergence of a ‘sense of urgency’ to attend to phone-related tasks in response to daily demands and life dynamics, offering a potential explanation for this behavior. Conclusion. The results of this study suggest common patterns of onboard mobile use among Mexican drivers concerning driving situations and associated risks. This underscores the need for increased efforts to discourage onboard phone use in the country.