the role of neck injury in a motor vehicle collision as a predisposing factor for future neck pain and disability is controversial. the purpose of this study is to determine whether a past history of neck injury in a motor vehicle collision was associated with incident troublesome neck pain. data from the saskatchewan health and back pain survey, a population based survey mailed to a stratified random sample of 2184 saskatchewan adults aged 20-69 years was used for the analysis. fifty-five percent of the eligible population participated and of those 74.8% responded to the six month and 62.9% at twelve month follow-up survey. the exposure was collected by asking participants whether they had ever injured their neck in a motor vehicle collision (n=122). the population at risk included those with no or mild neck pain at baseline (n=919). the association between the history of neck injury in a motor vehicle collision and the development of troublesome neck pain was analyzed with multivariable cox regression with adjustment for confounders. the history of neck injury in a motor vehicle collision was positively associated with the development of troublesome neck pain at six and twelve months (crude hazard rate ratio = 2.43; 95% ci 1.28-4.60). after adjusting for bodily pain and bmi, this association was reduced (hazard rate ratio = 2.14; 95% ci 1.12-4.10). this prospective cohort study suggests that a history of neck injury in a motor vehicle collision was a risk factor for the development of an episode of troublesome neck pain.