INTRODUCTION: The Pedestrian Hybrid Beacon (PHB) has become increasingly common since it was first implemented in 2015 at midblock pedestrian crossings in Massachusetts. The tri-signal head design includes signal sections displaying two red indications above a single yellow indication. PHBs are used as a method of increasing the safety of vulnerable road users by stopping vehicles at high-traffic and high-speed midblock crosswalks. This study was developed to evaluate both driver behavior and comprehension related to the use of PHBs in Massachusetts. METHODS: The study utilized one online survey to create a PHB inventory, and a second online survey to measure driver comprehension of PHBs. The first survey was motivated to gauge potential exposure to PHBs and supplied an estimated 40 PHB installations with a primary concentration in Eastern Massachusetts. These efforts were paired with the second survey that was disseminated to drivers in Massachusetts and elsewhere to investigate the typical driver's understanding of PHB intervals: Dark, Flashing Yellow (FY), Solid Yellow (SY), Solid Red (SR), and Flashing Red (FR). RESULTS: The comprehension survey's results provide evidence to suggest that driver behaviors are inconsistent with the recommended actions in PHB user guides. Specifically, the FY and FR intervals cause the greatest amount of confusion for drivers. CONCLUSIONS: This study also examines the reasons why drivers may be confused and offers recommendations for PHB education and outreach practices. PRACTICAL APPLICATIONS: PHBs can increase pedestrian conspicuity on midblock crossings. Correct use of PHBs by drivers and pedestrians is crucial for facilitating safe crossings and traffic flow. However, many research efforts have not studied drivers' understanding of PHB intervals. Communities with PHBs present should consider education and outreach prior to and during PHB implementation.