Public Private Partnerships (PPP) have become common in providing high-quality infrastructure in many countries worldwide. One of the main reasons for PPP agreements is to improve efficiency and quality in the delivery of public services, as well as to boost investments for expensive projects. Despite PPPs having been particularly widespread in the case of the construction and rehabilitation of high-capacity road infrastructure, their impact in terms of road safety outcomes is still unexplored. This paper studies the effects of PPPs on road safety outcomes by taking advantage of the variety of management models provided in the Spanish highway network. Results based on a panel-data fixed-effects method show that the most relevant aspect influencing road safety outcomes is the quality of design of the road. However, we find strong evidence suggesting that privately operated highways perform better in terms of road safety outcomes than publicly operated highways, for roads with a similar quality of design.