Vehicle ramming in crowded spaces: Risk epidemiology and implications for management

Vehicle ramming has become an increasingly important crowd safety concern in urban environments, yet its epidemiology and operational characteristics remain poorly understood. We compiled and analysed a global database of 180 documented vehicle-ramming incidents involving crowds between 2001 and 2025. The total number of identified incidents more than quadrupled in the most recent decade compared with the first decade of the study period, with nearly 70% of all incidents occurring between 2016 and 2025. Incidents were geographically concentrated, with nearly two-thirds occurring in just five countries: the United States, China, Israel, Germany, and France. Contrary to the common perception that vehicle ramming is primarily a form of terrorism, only 31% of incidents were classified as acts of terrorism. Reported mental health issues involving the perpetrator were documented in almost 27% of cases. Terrorism-related incidents were, on average, nearly twice as deadly as non-terrorism incidents, even after excluding the 2016 Nice attack as an outlier. Across all incidents, the average number of fatalities was 3.61, with the deadliest event (the 2016 Nice attack) causing 86 deaths. Almost 43% of incidents involved a secondary attack, most commonly, though not exclusively, a knife attack. These incidents resulted in substantially higher fatalities than incidents without a secondary attack (5.5 versus 2.2 fatalities per incident), and secondary attacks were not exclusive to terrorism-related events. Terrorism-classified incidents also involved considerably younger perpetrators than non-terrorism incidents (29.8 versus 37.5 years on average). Finally, we identified clear and statistically significant temporal clustering of incidents, with at least five major clusters of events occurring in close succession over the study period, suggesting that the occurrence of one incident anywhere in the world may temporarily increase the likelihood of subsequent events and create short periods of elevated risk that warrant heightened vigilance and preparedness. These findings provide an empirical foundation for understanding the evolving nature of vehicle ramming and for informing preparedness and mitigation strategies in crowded places.