The aim of this study was to gain a better understanding of, and to help form a more complete picture of, the perceived safety of wheelchair-seated passengers using special transportation services (STS). A questionnaire was sent out and completed by 801 respondents in five Swedish regions. Additional information was acquired by means of 15 subsequent in-depth interviews. It was found that 5% reported personal incident-related injuries during the period that they had been eligible for STS. Injuries were most likely to occur during normal driving, but the passengers were also exposed to risks during boarding and alighting procedures. Nevertheless, 80% of the passengers were basically satisfied with the degree of safety. A large majority (97%) reported that they always use tie-down systems, and 78% always use safety belts. These results indicate that, despite general satisfaction with the STS system as such, malfunction of the existing safety equipment is a problem, since safety is especially critical for STS passengers-a vulnerable road-user group with few alternative travel modes. Therefore, there is a need for wheelchair tie-down and occupant restraint systems (WTORS) that are easier to handle by the operators and more suitable for the passengers and their wheelchairs. A low-floor vehicle concept might also reduce injury risks related to boarding and alighting procedures.