Some 30.5 million Germans hold a driving license. For the person with a physical handicap, too, active traffic participation is of special importance, in that it constitutes an essential link in his rehabilitation. Road traffic authorities, in view of traffic safety, are held to consider both, the handicapped individual's interest in obtaining a license and society's claim to safety. Numerous studies have established the fact that disabled drivers, in particular those with impairment of the limbs, are neither more accident-prone nor otherwise more conspicious in road traffic than the non-disabled. The view that the driver with a physical disability poses particular risks, has been invalidated by extensive factual data and thorough literature review. Diseases of major relevance for driving ability are touched on, the range of adaptive equipment is exemplified. Physicians in accident surgery primarily have to deal with trauma to the spinal cord and limbs. The majority of these conditions permit good compensation by technical devices, enabling safe driving of a private car. Awareness of legal/administrative aspects of licensing, as well as of the adaptive potential of technical aids are of great importance to both physician and client.