Which elderly person may drive and who should decide? These questions translate a frequent doctor's dilemma. Driving is a tremendously complex perceptive, motor, cognitive, and emotional activity. Assessing someone's ability to drive requires investigating these various components. However, a driving test is often needed. Driving limitations and a psychotherapeutic approach may help a patient give up driving, but occasionally forcing them to quit driving may prove unavoidable. Ideally, a preventive approach initiated long before old age might help decrease the frequency of the old driver's dilemma.