The aim of this case–control study was to determine if there is an association between vehicle panel damage and AIS3+ thoracic injuries. NASS CDS data from 2001 to 2012 was examined for single vehicle rollover crashes with occupants receiving serious thoracic injuries (cases) and those without thoracic injuries (controls). Vehicle panel damage for cases and controls were coded and logistic regression performed to determine if there is an association between serious thoracic injury and vehicle panel damage. Furthermore, an investigation into the differences in injury sources and injury outcomes between front-seated near- and far-side occupants was performed with the data. There were two main findings from this study. First, there is an association between the rear left segment, front left upper-half door, and front right upper-half door damage and serious thoracic injury. Second, the sources of thoracic injuries and the thoracic viscera injured are different for near-side and far-side occupants.