As electric bicycles grow in popularity, so do questions about their safety. A review of nearly 200 studies published between 2009 and 2024 suggests the answer is more nuanced than many headlines imply.

The review, published in Transportation Research Interdisciplinary Perspectives, found no clear evidence that e-bike riders crash more often than traditional cyclists. However, researchers caution that this does not mean e-bikes are safer. Many e-bike crashes may go unreported, especially in the United States, because crash tracking systems are incomplete and e-bike involvement is not always recorded. As a result, the true number of e-bike crashes may be higher than current data suggests.

However, when crashes do occur, e-bike riders tend to experience more serious injuries. Compared with conventional cyclists, they are more likely to be hospitalized and to suffer severe head, face, and neck injuries, including traumatic brain injuries.

Researchers point to several possible reasons. Amir Ghanbari, PhD student in the University of Iowa’s Department of Epidemiology and corresponding author of the study, says that many e-bike crashes are single-vehicle events that do not involve another road user. “Because e-bikes are heavier and can reach higher speeds with motor assistance, riders may be more likely to lose control or balance, particularly without prior training, which may further contribute to these crashes,” he says.

Comparisons between e-bikes and e-scooters are less clear. Some studies found e-bikes to be safer, while others reported the opposite or found little difference. Researchers say inconsistent data and varying definitions of what constitutes an e-bike make comparisons difficult.

Researchers caution against viewing e-bikes as simply “safe” or “unsafe.” Instead, they say the growing popularity of e-bikes highlights the need for better infrastructure, clearer regulations, and rider education. “Well-designed bike lanes, evidence-based policies, and clear guidance on where e-bikes should be ridden, what safety equipment should be used, and who should be eligible to ride them could help reduce injuries while preserving the environmental, mobility, and accessibility benefits e-bikes provide,” Ghanbari says.

Overall, the evidence suggests that e-bikes offer significant advantages but come with distinct safety challenges. As their use continues to expand, thoughtful policies and safer riding environments will play a key role in determining whether e-bikes become a public health success story—or a growing source of preventable injuries.

Asha Weinstein Agrawal from the Mineta Transportation Institute at San José State University and Kevin Fang from the Department of Environmental Studies, Geography, and Planning at Sonoma State University are co-authors of the study.