We examined associations of functional impairments with vehicle crashes using telephone interviews of 244 elderly at-fault crash involved Mobile County, Alabama, drivers and 475 crash free controls, frequency matched on age and gender. Police-investigated crash reports filed in 1996 were obtained from the Alabama Department of Public Safety. After controlling for potential confounding, reported difficulty walking ≥ 1/2 mile (OR 2.0;​ 95% CI 1.2, 3.6), moving outdoors (OR 2.7;​ 95% CI 1.1, 7.0), and increasing numbers of activity limitations (p for trend=0.04) were associated with crash involvement. A 50% increased odds of crashing was observed for subjects reporting prior falls.