In the past five years, e-bike-related injuries have increased exponentially in the Fresno area, reflecting a nationwide trend. A UCSF Fresno critical care trauma surgeon, along with the injury prevention outreach specialist at Community Regional Medical Center, is raising awareness about the need for e-bike safety to help prevent injuries and deaths.
“The most striking thing to us is that the e-bike injuries have increased by close to 300% over the last five years,” said Amy Kwok, MD, a UCSF associate clinical professor and associate program director, UCSF Fresno General Surgery Residency.
The surge locally in e-bike injuries is alarming. Through June of 2026, there were 51 reported injuries, as compared to 38 for all of 2025; 21 incidents in 2024; 11 in 2023; and none in 2022.
“And the more concerning part is just how fast the pediatric injury group has grown,” said Kwok, who sees patients at Community Regional as an Inspire Health surgeon, and who is also involved with e-bike safety advocacy as the American College of Surgeons Committee on Trauma, Northern California State Chair.
“The increase in pediatric injury has more than increased by fourfold. And we’re looking at the age group of 12 to 15,” Kwok said. “And just by June of this year, we have already had more than double the injuries from 2025, and we haven’t even finished the year.”
In the 12- to 15-year-old age group, there have been 9 injuries locally through June. In 2023, there was one injury; in 2024, two; and in 2025, two.
And tragically, there have been four e-bike-related deaths as of June 2026.
Most of the injuries from e-bike accidents are to extremities, broken arms, broken legs, and broken pelvises; however, head injuries are also seen and are the most serious. “It has been, from what I have witnessed, that head injuries have been the reason for mortality,” Kwok said.
“The other thing we’re seeing is more and more increase in facial fractures, and that comes with head injuries,” she said. The national trend, looking at facial injuries, is on par or close to par with the facial fractures that are seen in patients who come in with motorcycle collisions, she said.
Head and facial injuries are devastating, particularly to children. “They are shorter, and they take most of the impact with their heads and faces,” Kwok said.
Too fast and without helmets
E-bike-related fatalities have two commonalities: Riders going at higher speeds and not wearing helmets.
There are three classes of e-bikes:
Class 1 or a “low-speed pedal-assisted electric bicycle has a motor that engages when the rider is pedaling but stops when the speed reaches 20 mph.
Class 2 e-bikes have a throttle-assist motor that can propel the bike without pedaling. The throttle assist also stops when the bike reaches 20 mph.
Class 3 e-bike (speed pedal-assisted) has a motor that allows the rider to reach up to 28 mph when pedaling. The motor stops at 28 mph.
Class 1 and 2 e-bikes are allowed on most bike paths – but not on sidewalks. Class 3 e-bikes are not allowed on bike paths or sidewalks.
In Clovis and Fresno, municipal codes prohibit riding a bicycle, e-bicycle, or e-scooter of any kind on sidewalks in many locations.
It’s illegal to make a motor-assisted bicycle go faster than the authorized speed for its class, but conversion kits that are bought online allow the bikes to go much faster, said Jennifer Champlin, injury prevention specialist at Community Regional. “State legislation banned them last year in the state of California, but they essentially ‘jailbreak’ an e-bike motor and can change the top speed from 20 to 28 mph, which essentially makes it no longer an e-bike.”
“You’re having 13- to 15-year-olds that don’t have even a driver’s license driving the e-bikes at 50 to 60 mph on the road. And where that leads to is that we are seeing a real increase in e-bikes versus auto collisions,” Kwok said, and those collisions often involve serious, if not fatal, head and facial injuries.
Considering the uptick in e-bike-related injuries, Champlin said prevention and outreach are more necessary than ever. “We know the most important thing we can do to offset some of the injuries is to have people who are using e-bikes to be wearing helmets, and the right type of helmet, and correctly fitting helmets.”
A new version of a helmet made for higher-speed e-bike riders can be purchased, Champlin said. “Specific e-bike helmets have been designed to better withstand the impact of a higher-speed crash.”
Sadly, data from Community Regional shows that only 25% of injured e-bike riders of all ages were wearing helmets, Kwok said.
According to Fresno Police, class 1 electric bikes have no age restrictions and require a helmet for riders under 16. All Class 2 e-bike riders under the age of 18 must wear a helmet. Class 3 e-bikes require riders to be 16 years old or older and require helmets for all riders, regardless of age.
Champlin said other safety advice for e-bike riders includes wearing bright or reflective clothing and using lights. (Legislation (Assembly Bill 2346, pending signature by the governor would require all e-bikes manufactured or sold after Jan. 1, 2029, to have a front lamp and a rear lamp.)
“It is imperative that we are able to see our e-bike riders,” Champlin said. “Wearing dark clothes on any type of bike in the evening or nighttime, when it’s starting to get dark, makes seeing riders very difficult by other road users.”
Kwok and Champlin stressed the importance of knowing how to ride safely. “Know the rules of the road that you’re riding on. What are the areas like? What are the appropriate areas you can ride in? Is that the bike lane? And then ride as safely as possible. Make sure your speeds are really where they’re supposed to be. E-bikes are not made or safety-wise tested for higher speeds. And always, always wear a helmet – every time you ride.”
