This paper describes a driving assessment and training program that is primarily for patients discharged from the hospital and who may be experiencing residual impairment from some form of brain damage. Assessment is carried out by an occupational therapist and consists of several off-road tests (vision, reaction timing, computerized preview tracking test, general medical psychological appraisal), and an on-road test. More than 300 patients have been seen since the program’s inception in 1977, and trends indicated by their assessment results are: twice as many male as female referrals; a low fail rate among nonbrain-involved patients; diagnosis as a poor predictor of outcome; no significant difference between fail rates of right and left stroke patients; significant difference in average tracking task performance between the Pass, Borderline, and Fail assessment groups. Off-road testing complements, rather than replaces, on-road testing. Thirty-eight of the 300 patients were given special training, and 15 of these were unable to reach an acceptable level. This reflects a difficulty in predicting the outcome of unlicensed patients with severe disabilities.