The objective of this study was to undertake a rigorous before-after evaluation of the safety effectiveness of cable median barriers in combination with inside shoulder rumble strips along divided roads. The study used data from three States—Illinois, Kentucky, and Missouri—to examine the effects for specific crash types, including total, fatal and injury (KABC and KAB), and cross-median crashes. This study did not include crashes occurring at or related to an intersection and animal-related crashes.