Last place honours went to Milton, Ont.
The ranking comes after Allstate Insurance looked at all the claims it has paid out in 50 Canadian cities.
However, the study says Calgary drivers are getting better behind the wheel.
It found Calgary's collision rate dropped 3.9 per cent over the last four years.
But some Calgarians say they aren't seeing any improvements.
"People are still driving crazy, they are right on your butt all the time, they don't use their turning signals," said Ron Carson.
"I turn on the radio every morning and I hear of two or three accidents," said Tanya Utanda.
Medicine Hat the safest, according to study
But it isn't all bad news for Alberta drivers. Medicine Hat ranked at the top of the list of 50 cities and Lethbridge was close behind in fourth spot.
Sarnia, Ont., came in second and Spruce Grove, Alta., settled into third place.
The 50 Canadian cities were ranked by the frequency of collisions per 100 cars insured by the company.
While All State also says Alberta has the highest number of motor vehicle collisions, many provinces were not included.
Data was only collected in Alberta, Ontario, New Brunswick and Nova Scotia over a two-year period from July 1, 2011, to June 30, 2013.
But agency manager Anthony Chan says collisions in Alberta are also down 7.4 per cent.
"We're still on the bottom half in terms of the number of collisions per 100 compared to a lot of large cities, but in terms of Alberta we are seeing some improvement," he said.
Chan says if collision rates continue to improve in Alberta, motorists could see lower insurance premiums in the future.