To test the hypothesis that migraine is associated with motor vehicle driver injury, data collected from 10,529 individuals on personal history of migraine and motor vehicle injury were analysed cross-sectionally. In multiple logistic regression analyses, the adjusted odds ratio for motor vehicle driver injury associated with migraine was 2.3 [95% confidence interval (CI) 1.9-2.7]. After excluding those who also had a history of head injury, the odds ratio was 1.5 (95% CI: 1.2-2.0). These results suggest that migraine may be associated with a 50% increase in the risk of motor vehicle driver injury and that in this population may account for as many as one in every 20 motor vehicle driver injuries. These findings require confirmation in prospective studies of motor vehicle driver injuries.