Novel York City saw a 41% increase in e-bike injuries in 2025, with 901 reported cases, as cities nationwide grapple with a surge in trauma from electric micromobility that is overwhelming emergency rooms and prompting urgent debates over prevention.
The rise in injuries mirrors a steep national climb: from 1,600 e-bike-related trauma cases recorded across the U.S. In 2018 to 23,000 by 2022, according to data cited in Jama Surgery and referenced by city officials and medical researchers. During the same period, e-bike sales jumped from 50,000 units to 527,000, driven by market growth that analysts project will push the U.S. E-bike industry from $4.4 billion in 2026 to over $6.2 billion by 2031.
At Bellevue Hospital in New York City, micromobility injuries — including those from e-bikes, e-scooters, and traditional bicycles — accounted for 7% of all trauma visits between 2018 and 2023, a figure echoed in a separate NYU Langone Health study showing such incidents now represent nearly half of all emergency room trauma cases linked to bikes and scooters, up from less than 10% in 2018. The study, published in Neurosurgery on April 15, analyzed 914 patients treated at NYC Health + Hospitals/Bellevue between January 2018 and August 2023.
Of those patients, one-third sustained traumatic brain injuries, more than two-thirds required hospital admission, and roughly 30% needed intensive care. Alcohol was a factor in about one in five cases, correlating with more severe brain injuries and lower helmet use, which was reported by fewer than one-third of riders. Pedestrians struck by e-bikes or scooters suffered brain injuries at nearly double the rate of riders, underscoring the risk to those not operating the vehicles.
The most common cause of injury in both studies was a collision with a car or truck, accounting for approximately half of all cases. This finding has intensified debate among safety advocates over whether resources should prioritize infrastructure improvements — such as protected bike lanes and traffic calming — over rider regulation like speed limits or licensing requirements.
“When we think about e-bike crashes and deaths related to e-bikes, the vast majority are cars and trucks killing people on e-bikes as opposed to people on e-bikes injuring somebody else,” said Alexa Sledge, director of communications for Transportation Alternatives, a New York-based advocacy group. “What we really want to see is an improved and expanded infrastructure to protect people that are biking, protect people that are walking and build sure that there are different protected areas for all types of transportation.”
That perspective contrasts with cases like that of Roberta Simon, an attorney who was walking in Central Park in August 2024 when a teen on an e-bike collided with her. She sustained a traumatic brain injury, required 40 staples in her skull and a throat tube, and spent six months recovering before returning to daily activities. “I can’t stress enough how lucky I am,” she said. Her incident was among 17 e-bike-related fatalities in New York City in 2024, according to the city’s Department of Transportation.
Similar trends have emerged in other regions: Tampa Bay, Florida, recorded at least 28 e-bike-related deaths over five years, prompting a local pediatric emergency physician to describe the injury pattern as causing a “paradigm shift” in emergency medicine. In California, two towns near San Diego declared states of emergency following fatal e-bike crashes, reflecting growing pressure on local governments to respond.
Medical experts warn that standard bicycle helmets offer limited protection at the higher speeds now common with e-bikes, which can exceed 20 mph and approach motorcycle velocities. As one emergency medical technician instructor noted in a Santa Barbara City College course, the brain’s gel-like consistency makes it vulnerable to deceleration injuries — where the organ strikes the inside of the skull upon sudden stop — a mechanism that no external helmet can fully prevent, much like in shaken baby syndrome or repeat trauma seen in football players.
Instructors in youth safety programs emphasize that adolescents operating e-bikes in traffic often lack the judgment to manage high-speed vehicles, especially when riding without helmets or signaling turns. One observed incident involved two teenage girls cutting across three lanes on Hollister Avenue in Santa Barbara, narrowly avoiding a collision with a pickup truck whose driver anticipated their move.
With helmet use low, alcohol involvement notable, and injury patterns peaking between 6 and 8 p.m. — coinciding with dinner-hour delivery traffic — experts say solutions must combine behavioral, infrastructural, and regulatory approaches. The NYU Langone researchers concluded that helmet promotion, safer bike lane design, and stricter enforcement could prevent many injuries, particularly as e-bike use continues to expand among commuters, delivery workers, and recreational riders.
Why are pedestrians suffering more severe brain injuries than e-bike riders in crashes?
Pedestrians struck by e-bikes often experience more severe brain trauma as they lack any protective gear and are typically hit at higher speeds by vehicles whose riders may be going faster than expected, increasing the force of impact and the likelihood of deceleration injury to the brain.
What role does alcohol play in e-bike injury severity?
About one in five e-bike injury patients tested positive for alcohol, which was linked to both worse brain injuries and lower helmet use, compounding the risk of severe trauma in crashes.
