A systematic review of literature related to the impact of modifications made to automobiles on the driving ability, performance, and safety of older adults was completed as a part of the Evidence-Based Literature Review Project of the American Occupational Therapy Association. This review evaluated research on high-tech options, such as advanced technology systems (Intelligent Transportation Systems) currently in active development by manufacturers and researchers and the effect of features such as the instrument panel and window tinting. Although the evidence related to Intelligent Transportation Systems is inconclusive, studies have indicated that older adults would use selected technology options. Aftermarket window tinting negatively affects older adults’ driving performance, and no evidence demonstrates that hydrophobic window treatment improves driving performance. The implications for occupational therapy practice, research, and education also are discussed.