BACKGROUND/AIM: Specialist Occupational Therapy Driver Assessors and driver licensing authorities require on-road assessment procedures that are both valid and reliable. Assessment validity may be influenced by both test route characteristics and driver characteristics. To address these issues, this study aimed to evaluate the characteristics of test routes used by Occupational Therapy Driver Assessors (including associated driving manoeuvres and traffic conditions) and to explore Occupational Therapy Driver Assessor views relating to on-road assessment procedures. METHODS: In-depth interviews of 22 Occupational Therapy Driver Assessors were conducted; seven of the routes examined were in rural or regional locations. Supplementary information was obtained by observation of routes and review of Occupational Therapy Driver Assessors' route documentation. RESULTS: All Occupational Therapy Driver Assessors reported using a standard test route for clients seeking an open (i.e. not geographically restricted) licence. Compliance with professional guidelines reassessment procedures was very high for test items designated as compulsory, but more variable for those designated only as desirable. Differences between rural/regional vs. urban routes were noted, with those in rural/regional areas being less cognitively demanding. CONCLUSIONS: This study highlighted variation in route complexity between urban and rural locations. Whereas compliance with current professional guidelines for compulsory route items was very high, more detailed specification of standard route requirements is needed to improve the construct and content validity of assessments.