At Bellevue Hospital’s trauma bay, Hannah Weiss kept hearing the same refrain during her residency shifts: “Another patient fell off an e-bike, another patient fell off a scooter. Pedestrian hit by e-bike, pedestrian hit by scooter.” What began as an occasional concern became a pattern she could no longer ignore.
A new study led by Weiss, a resident in NYU Langone’s neurosurgery department, confirms what she witnessed firsthand. Researchers analyzed 914 patients treated for bike and scooter injuries at NYC Health + Hospitals/Bellevue between January 2018 and August 2023. The share of trauma cases involving micromobility devices—bicycles, e-bikes and e-scooters—jumped from under 10 percent in 2018 to over 50 percent by 2023. More than two-thirds of these patients required hospital admission, and roughly one-third suffered traumatic brain injuries.
The data reveals a stark shift in injury patterns. While traditional bicycle accidents once dominated, electric vehicles now account for the majority of micromobility-related trauma. Nearly half of all injured patients were struck by cars or trucks, the most common cause of injury. About one in five tested positive for alcohol, which correlated with both lower helmet use and more severe brain injuries. Fewer than one-third of riders wore helmets at the time of impact.
Pedestrians face disproportionate risks. The 69 pedestrians in the study who were struck by electric vehicles suffered brain injuries at nearly double the rate of riders. Roberta Simon, an attorney walking in Central Park in August 2024, experienced this firsthand when a teen on an e-bike collided with her. She awoke four days later with a traumatic brain injury, 40 staples in her head, and a tube in her throat. It took six months to resume her daily activities.
Seasonal trends intensify the burden. Spring and summer remain the busiest periods for these injuries, as New Yorkers swap subway rides for bikes. In the spring and summer of 2022, nearly 150 injured patients arrived at Bellevue—about three times the number treated during the same seasons in 2018. Although 2023 data was incomplete, the figure dipped slightly from its 2022 peak.
For more on this story, see E-Bikes and Scooters Linked to Surge in Brain and Spine Injuries.
The rise of e-bikes mirrors broader urban shifts. Delivery workers and commuters have embraced electric vehicles for their speed and efficiency, but safety practices have not kept pace. Weiss noted that common-sense precautions like helmet use and sobriety are frequently ignored, exacerbating injury severity. Meanwhile, lithium battery fires and fatal crashes have drawn scrutiny from lawmakers, prompting NYPD Commissioner Jessica Tisch to lead a crackdown on e-bike operators and Citi Bike to cap its e-bike speeds at 15 miles per hour.
Solutions remain contested. Transportation Alternatives’ Alexa Sledge argues that the vast majority of e-bike fatalities involve cars and trucks striking riders, not the reverse. She advocates for expanded protected infrastructure—dedicated bike lanes, pedestrian zones, and traffic calming—over stricter rider regulations. At Bellevue, Dr. Ashley Pfaff, a trauma surgeon, said she sees an e-vehicle injury “every single day,” underscoring the strain on emergency resources.
The financial scale of the trend is significant. E-bike sales surged from 50,000 units in 2018 to 527,000 in 2022, according to Circana. The US e-bike market, valued at roughly $4.4 billion in 2026, is projected to exceed $6.2 billion by 2031. Nationally, e-bike injuries climbed from 1,600 in 2018 to 23,000 in 2022, per Jama Surgery. In New York City alone, e-bike injuries rose 41 percent from 2024 to 2025, reaching 901 incidents, per the transportation department.
History offers a parallel. When automobiles first flooded city streets in the early 20th century, injury rates spiked before traffic laws, infrastructure, and safety norms caught up. Today’s micromobility surge follows a similar arc: innovation outpacing protection, leaving hospitals like Bellevue to manage the consequences.
Why are pedestrians at higher risk of brain injury from e-bikes?
Pedestrians struck by electric vehicles in the study had brain injuries at nearly double the rate of riders, likely due to lack of protection and unexpected impact forces.
What role does alcohol play in e-bike injuries?
About one in five patients tested positive for alcohol, which was linked to lower helmet use and more severe brain and facial injuries.
How has Bellevue Hospital responded to the rise in micromobility injuries?
Bellevue’s trauma team has seen micromobility injuries account for over half of related emergency cases, with more than two-thirds requiring admission and roughly 30 percent needing intensive care.
