For enhanced safety, the front and second-row seat shoulder belts of the Acura MDX have pretensioners to tighten the seatbelts and eliminate dangerous slack in the event of a collision and force limiters to limit the pressure the belts will exert on the passengers. The Toyota 4Runner doesn’t offer pretensioners for its second-row seat belts.
In a Vehicle-to-Vehicle Frontal Crash Prevention 2.0 test conducted by the Insurance Institute for Highway Safety (IIHS), the Acura MDX achieved a “Acceptable” rating - the second highest possible - for its performance in forward collision warning and automatic braking systems, demonstrating its excellent capabilities in preventing collisions. The Toyota 4Runner has not been tested.
For better protection of the passenger compartment, the MDX uses safety cell construction with a three-dimensional high-strength frame that surrounds the passenger compartment. It provides extra impact protection and a sturdy mounting location for door hardware and side impact beams. The 4Runner uses a body-on-frame design, which has no frame members above the floor of the vehicle.
Both the MDX and the 4Runner have standard driver and passenger frontal airbags, front side-impact airbags, driver and front passenger knee airbags, side-impact head airbags, height adjustable front shoulder belts, four-wheel antilock brakes, traction control, electronic stability systems to prevent skidding, crash mitigating brakes, daytime running lights, lane departure warning systems, blind spot warning systems, rearview cameras, rear cross-path warning, driver alert monitors, available all wheel drive and around view monitors.
The Acura MDX achieved a “Top Safety Pick” rating from the Insurance Institute for Highway Safety (IIHS) for the 2025 model year. This recognition was based on its impressive performance in the small overlap frontal crash test, updated moderate overlap front crash test, updated side impact crash test, headlight evaluations, and pedestrian crash prevention testing. The 4Runner has not yet been evaluated by the IIHS for 2025.

