An artificial intelligence trial identified almost 19,000 potential driving offences in Birmingham and Wolverhampton in just two weeks.
West Midlands mayor Richard Parker called the findings "shocking" saying the number of drivers putting themselves and others at risk was "far higher than we expected".
The trial used AI-powered cameras outside Ladywood and Fallings Park fire stations in March to identify potential seatbelt and mobile phone offences.
The images they captured included a front-seat passenger holding a small child on their lap without a seatbelt and a driver holding a mobile phone with both hands.
Dozens of images showed children travelling without age-appropriate restraints.
At Ladywood, the technology identified 11,045 potential seatbelt offences and 1,163 potential mobile phone offences. At Fallings Park, it recorded 6,030 potential seatbelt offences and 757 potential mobile phone offences.
Parker said: "The number of people risking their own lives and the lives of others, including some very young children, is frankly shocking and far higher than we expected.
"I've met families who have lost loved ones to reckless driving," he added. "They never recover from those tragedies."
He said he would use "every resource available" to make roads safer as the findings were reviewed.
The trial was funded by the West Midlands Combined Authority working with the police and fire service. No enforcement is planned as a result of the trial, which was intended to establish the potential scale of mobile phone use and failures to use child restraints.
Simon Foster, West Midlands police and crime commissioner and chairman of the region's road safety partnership board, said the findings were "deeply concerning".
"We are closely evaluating these trial results to consider how this advanced AI technology can be deployed for future police enforcement," he added. "We will use every effective tool at our disposal to ensure our roads are safer."
Mat MacDonald, the West Midlands road safety commissioner, said mobile phone use at the wheel and failing to wear a seatbelt were two of the leading causes of death and serious injury on the region's roads.
The WMCA said road safety data for last year showed mobile phone use was linked to 32 deaths on UK roads while unfastened seatbelts were linked to 133 deaths.
About 2,000 drivers a year in the West Midlands are fined and given penalty points for using a phone while driving.