As our elderly population continues to increase, diseases that are more prevalent with aging, such as Alzheimer's disease, are assuming ever greater relevance for society and the practicing clinician. An important practical situation faced by physicians caring for individuals with Alzheimer's disease is advising the affected individuals, their families, and often the licensing authorities about whether the patient can safely drive an automobile. Surprisingly, there is little guidance on how to arrive at a clinical impression of the fitness of an individual with Alzheimer's disease to drive. This article outlines potential inadequacies in driving skills that may occur with elderly people in general, and more specifically those with Alzheimer's disease. Studies that focused on Alzheimer's disease and driving are then reviewed. We conclude with recommendations for dealing with the problem of driving abilities in Alzheimer's disease.