A total of 328 drivers who died as the result of highway crashes was investigated, using autopsy records and police reports. There was no correlation between driver responsibility for the crash and autopsy evidence of disease or physical disability. Arteriosclerotic heart disease was found with similar frequency in drivers at fault and drivers not at fault. Several findings indicated that a decreased ability to survive crashes caused older persons to be greatly overrepresented among fatally injured drivers. The proportion of drivers who were 60 years of age or older was five times as high among those killed as among drivers who survived multivehicle crashes. Delayed death was more common among older drivers and was associated with less-serious injuries than in younger drivers.