E-bikes and scooters are driving a surge in serious brain injuries among urban riders and pedestrians, with these micro-mobility devices now responsible for nearly 7 percent of all trauma hospital admissions in New York City. A five-year study led by NYU Langone Health researchers found that one-third of the 914 patients treated for e-bike and scooter injuries suffered traumatic brain injury (TBI), a condition where sudden impact damages brain tissue and can cause lasting cognitive problems .

Why Are E-Bike and Scooter Injuries Becoming More Common?

The problem is growing fast. Between 2018 and 2023, the share of trauma cases involving these devices jumped from under 10 percent to more than 50 percent at NYC Health + Hospitals/Bellevue, the hospital where the research was conducted . The most common cause of injury was collision with a car or truck, accounting for roughly half of all cases. Researchers also found that injuries peaked between 6 p.m. and 8 p.m., suggesting that heavy dinnertime e-bike delivery traffic may be a significant factor in the rising injury rates.

The severity of these injuries is striking. More than two-thirds of patients required hospital admission, and about 30 percent needed intensive care . Many of these patients required neurosurgery, meaning the brain and spine damage was serious enough to demand surgical intervention.

Who Is Most at Risk, and What Makes Injuries Worse?

While riders face significant risks, pedestrians struck by e-bikes and scooters are in even greater danger. The 69 pedestrians analyzed in the study suffered brain injuries at nearly double the rate of riders themselves . This suggests that the speed and weight of electric devices pose a particular threat to people on foot who have no warning or ability to brace for impact.

Two major factors dramatically increase the severity of injuries. Fewer than one-third of riders wore helmets, and this choice had serious consequences. Helmet use was linked to significantly lower rates of brain and facial injuries. Additionally, about one in five patients tested positive for alcohol, which was tied to both worse brain injuries and lower helmet use rates .

How to Reduce Your Risk of E-Bike and Scooter Brain Injuries

• Wear a helmet every time: The research shows that helmet use significantly reduces brain and facial injury rates, yet fewer than one-third of riders in the study wore one. A properly fitted helmet is the single most effective way to protect your brain in a crash.
• Avoid riding under the influence: Alcohol impairs balance, reaction time, and judgment, making crashes more likely and injuries more severe. The study found that riders who tested positive for alcohol sustained worse brain injuries overall.
• Stay alert during peak traffic hours: Injuries peaked between 6 p.m. and 8 p.m., likely due to heavy delivery traffic. If possible, avoid riding during these times or use extra caution when sharing the road with e-bike delivery services.
• Use protected bike lanes when available: Collisions with cars and trucks caused about half of all injuries. Protected infrastructure separates riders from vehicle traffic and reduces collision risk.

Researchers emphasized that the problem extends beyond individual behavior.

"Our study shows that micromobility injuries are producing serious brain and spinal trauma that demands neurosurgical care at a scale we haven't seen before. In a busy urban setting, we are seeing more and more of these injuries firsthand. The data point to actionable solutions, helmet use, safer bike lane design, and enforcement, that could prevent many of these injuries and better protect both riders and pedestrians, who in our study often sustained even more severe brain injuries than the riders themselves," said Hannah Weiss, a resident in the department of neurosurgery at NYU Grossman School of Medicine.

Hannah Weiss, Resident in the Department of Neurosurgery, NYU Grossman School of Medicine

The research team reviewed medical records for every patient treated by the trauma team at Bellevue between January 2018 and August 2023 for injuries involving bikes or scooters. They collected detailed information on helmet use, alcohol levels, injury type, brain scans, surgeries performed, and length of hospital stay .

City infrastructure and policy changes may be equally important as individual precautions.

"Our findings make clear that urban infrastructure must continue to improve to keep pace with the rapid rise of electric bikes and scooters. Future studies should track these injuries across multiple cities and measure whether protected bike lanes, helmet programmes, and speed enforcement actually reduce the number of brain and spine surgeries we perform," noted Paul P. Huang, associate professor in the department of neurosurgery at NYU Grossman School of Medicine and chief of neurosurgery at NYC Health + Hospitals/Bellevue.

Paul P. Huang, Associate Professor of Neurosurgery and Chief of Neurosurgery, NYU Grossman School of Medicine and NYC Health + Hospitals/Bellevue

As e-bikes and scooters become increasingly common in urban areas, the medical system is seeing the consequences firsthand. The data from this five-year study provides clear evidence that without action on multiple fronts, brain injuries from these devices will continue to rise. For riders and pedestrians alike, the message is urgent: protect yourself with a helmet, stay sober, and advocate for safer city infrastructure designed to keep everyone safe.