The objective to this study was to examine the ability of emergency physicians to correlate between vehicle damage and velocity change. Participants were five emergency medicine physicians at the Emergency Department, Loyola University Medical Center, Maywood, IL. Ten slides of passenger cars crashed at speeds between 22 and 70 mph by the Insurance Institute for Highway Safety were shown to study participants. Study subjects were asked to estimate vehicular velocity based on the visible damage. Only 23 (46%) of the estimates were within 10 mph of the vehicular speed at the time of the crash. The average error was 14.5 mph (range: -20 to +45 mph). Vehicular velocity was overestimated in 70% of the appraisals. We conclude that the ability of emergency physicians to correlate between vehicle damage and velocity change is limited. Underestimation of vehicular damage associated with low velocity accidents may result in misdiagnosis of severe injuries in motor vehicle accident victims.