We investigated (1) the psychometric properties of data gathered with the Performance Analysis of Driving Ability (P-Drive), an on-road assessment; (2) P-Drive’s predictive validity in relation to a summed decision of passing or failing a medical driving evaluation; and (3) the success of implementing P-Drive. Drivers (N = 99) with neurological impairment referred for a driving evaluation were observed on road and scored using P-Drive. Results showed evidence of person response validity and internal validity. P-Drive separated the drivers into four different strata (reliability coefficient = .92). A cutoff raw score of 81 was optimal, with sensitivity of 93% and specificity of 92%. Although only 9 occupational therapists (of 19 initially trained) contributed data for analysis, 17 reported using the assessment. Data gathered with P-Drive yielded evidence of excellent psychometric properties. Moreover, P-Drive was implemented successfully in clinical settings, although initial training to full implementation took longer than 1 yr.