Background: Several countries in the world have distinct policies and frameworks to assessment and promote fitness to drive in the elderly. Accordingly, this study has been conducted to analyze the processes, models, and policies to assessment fitness to drive and improving driving in the elderly in the world.Method: Expected data were collected using keywords older, old, elderly, aging, ageing, senior, polic*, process, programme, plan, guideline, framework, driving capacity, driving eligibility, safe drive, fitness to drive, renewal driving license, commercial driver, driving qualification, driving ability, driving evaluation, driving assessment and their Persian equivalents from various English-language databases included: PubMed, Web of Science, Scopus, Embase, and Persian-language databases Included: IranDoc, SID, and MagIran. In this study, the Arkesy and O’Malley frameworks were employed.Results: Eventually, 24 papers and reports were included in the study. Vision assessment was the main item to judge the fitness to drive in the elderly, followed by driving assessment, cognitive assessment, and motor assessment. The in-person, postal, and online renewal of license were the most common method of renewal. General practitioners were the principal performers to measure driving fitness. In most all reports and papers, there were policies on empowering the elderly driver, including providing safe driving tips, optional driving skills tests, holding retraining courses, and so on. The most significant supporting policies included introducing alternative transportation to preserve the independence of the elderly. This study explained that clinical assessment is normally performed in drivers older than 75 years old to diagnose disorders and treat and prevent them in distinct time periods.Conclusion: Most high-income countries have worthwhile experience in measuring and improving the fitness to drive in the elderly and enforce different laws according to environmental, social, and political conditions. Utilizing these experiences by considering economic and social differences can be useful and practical for middle and low-income countries.