Older drivers are currently over-represented in severe injury crashes at intersections due in part to increases in frailty and functional disabilities that occur with age. Moreover, this rate is expected to increase as older people drive more and the population ages. Road design plays a major role in road safety and is likely to contribute to the driving difficulties of the elderly because of the general lack of consideration of the needs of older road users. Intersections, in particular, stand out as a major problem for older road users. This paper reviews age-related performance deficits that affect driving and describes a crash ‘black-spot’ site analysis that examined the relationship between intersection design features (believed to influence the safety of older drivers) and the older driver crash experience in Australasia. A number of intersection design problems for older drivers were identified and recommendations for changes in road design features and traffic management practices that have the potential to reduce crash and injury risk for older drivers at intersections are made.