Aim: This study systematically reviewed the literature on motor vehicle crash (MVC) risk for drivers with hearing loss in medicine, psychology, and transport databases, that quantify its effect on MVC to enable licensing agencies to make evidence-based decisions on fitness-to-drive hearing standards.Results: 1717 articles were identified of which 563 were duplicates. Twelve studies were retained for full-text review of which four published between 1968 and 2016 were judged to have met all the selection criteria. Three studies demonstrated no significant increase in MVC risk, while one reported a decrease in risk.Conclusions: Although the small number of studies that met all the inclusion criteria is a limitation, the expert panel concluded that the quality of the studies permitted the conclusion that the evidence does not support a relationship between hearing impairment and the risk of an MVC. Driver fitness standards recognise this fact implicitly in that none of the national fitness-to-drive standards selected for comparison applied licence restrictions to non-commercial drivers.