29 patients with brain lesion and 29 matched controls completed a neuropsychological test battery to assess perceptual, cognitive, and executive functioning and were tested on driving performance in a simulator and actual road conditions. The patients were socially well recovered with a high rate of employment. Patients performed significantly worse than controls on the test battery, especially on executive and cognitive functions. Patients drove as well as controls in predictable situations in the advanced simulator used In unpredictable situations, patients demonstrated longer reaction time (RT) and safety margins, as well as difficulties in allocating processing resources to a secondary task. Patients showed significantly less attention, worse traffic behavior, and less risk awareness when driving in real traffic. 41% of the patients did not pass the driving test. The neuropsychological test battery was factor analyzed into 4 factors: executive capacity, cognitive capacity, automatic attentional capacity, and simple perceptual-motor capacity. The second factor was the most significant, with a simultaneous capacity test predicting driving performance with 78% confidence.