Alcohol-related crashes and fatalities have shown a dramatic decrease over the last decade. While males continue to account for most alcohol-related crashes, females are an increasing proportion of alcohol-involved drivers in both fatal and nonfatal crashes. Although most research has not addressed the possibility of gender differences in the effects of alcohol on driving performance, available evidence suggests that such differences may exist. Alcohol appears to have greater effects on females in terms of biomedical damage and impaired performance, although these effects have not been systematically investigated in relation to driving. Effective prevention programs for women require more focused research to understand gender-related factors in the effects of alcohol on driving.