A prospective study was carried out between October 1992 and June 1994 to investigate the effect of epilepsy as a risk factor in road traffic accidents (RTA) and casualties in the United Arab Emirates (UAE). The aim of this paper was to investigate the risk and effect of epilepsy on road traffic accidents and casualties and identify possible risk factors for traffic accidents and casualties and identify possible risk factors for traffic accidents and violations among these drivers. Most (70%) were young drivers and under age 40 years; 43% were UAE nationals; 41% had a primary school education; 48.8% had a full license to drive private or commercial taxis; 41% had less than two years driving experience and 17.1% used seat belts regularly. Most (65.9%) admitted to crossing red traffic lights; 46.3% to parking in forbidden areas; 66% to speeding; 36% to smoking while driving; 34.1% to using the telephone whilst driving; 43.9% to putting their child in the front seat; 20.8% had been previously involved in an RTA; and 53.7% had sustained serious injury. A figure of 34.1% had at least one seizure per year and 26.8% had at least one seizure per month. The most common violations were careless driving (34.1%) and traffic regulation violations (24.4%). Significantly higher risk was observed for property damage (RR = 1.85; 95% CI = 0.64-5.14) and traffic violations (RR = 1.91; 95% CI = 0.54-2.29). In the UAE there are no restrictions on the issue of driving licenses to people prone to epileptic seizures. In conclusion, it is emphasized that patients with conditions such as epilepsy should feel obliged to inform the traffic authorities or the health authorities about their condition. It seems likely that the problem could be greatly reduced if appropriate action was taken concerning epileptic drivers. It is hoped that the results and recommendations of this study will be useful to traffic and health authorities.