In 1910 New York became the first state to pass a drunk driving law, with California and others soon following. That year there were less than 150 miles of paved roads in the nation and fewer than 8,000 motor vehicles.

George Smith, a London taxi driver, is believed to be he first person to be convicted of drunk driving, on 10 September 1897. He was fined 20 shillings about $4.60.

Early laws simply prohibited driving while intoxicated, requiring proof of a state of intoxication with no specific definition of what level of inebriation qualified. The first generally-accepted legal limit for blood alcohol concentration (BAC) was 0.15.

In 1938, the American Medical Association created a "Committee to Study Problems of Motor Vehicle Accidents". At the same time, the National Safety Council set up a "Committee on Tests for Intoxication".

In the US, most of the laws and penalties were greatly enhanced starting in the late 1970s, and through the 1990s, largely due to pressure from groups like Mothers Against Drunk Driving (MADD) and Students Against Driving Drunk (SADD) and leaders like Candy Lightner. Significantly, zero tolerance laws were enacted which criminalized driving a vehicle with 0.01 or 0.02 BAC for drivers under 21. This is true even in Puerto Rico, despite maintaining a legal drinking age of 18.

Drunk driving crashes remain the leading cause of death of young Americans nearly 18,000 Americans were killed in alcohol related crashes last year.