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I've been driving over 20 years, but never outside the US. European driving is quite different, I hear, both rule of the road and other drivers' habits. If I was to drive in Europe what should I learn and how? Is it possible to take a "European Driving" course while still in US, so that I would arrive to Europe ready to rent a car on the 1st day? By "Europe" I mean continental EU, Germany and neighbors, not the left-side-of-the-road UK.

I've driven for many years in the US and also gone through the process of getting my driver's license (again!) in the Netherlands. The below is based on my experience and there are some subtle differences between countries so beware.

First, to get it out of the way, almost all cars in Europe are manual transmissions, although some rental cars are automatics. In fact, if you take your driving test with an automatic, you are not allowed to drive a manual transmission until you take the exam again (after a mandatory 2 year waiting period!) with a manual transmission.

The other answers touch on some common things, but the single most important difference is in right-of-way. In Europe, they rely much less on stop signs and stoplights to regulate traffic. Instead, they rely more on traffic circles, "shark's teeth" and right-of-way rules. There are some other things as well.

Traffic Circles

There are two major forms of traffic circles: standard ones and "turbo" ones. Standard ones are the usual ones where one could potentially drive around them indefinitely. Turbo traffic circles may have one or two lanes for traffic entering from each side and do not permit making a full trip around the circle. Instead, one lane typically allows exiting to the right or straight across the circle, while the other permits exiting straight cross or 3/4 of the way around.

Shark's Teeth

Shark's teeth are just yield signs painted on the road in a "teeth" pattern. Much like there is a white line painted on the road where there is a stop sign in the US, these shark's teeth indicate you are to yield to traffic at the intersection.

Right-of-Way

The right-of-way rules take the most time and practice to get used to. There are two important aspects to this:

1. In the absence of other indications on right-of-way, you must yield to the person coming from the right.


2. Yellow diamonds are used to indicate when your road has right-of-way and you do not need to do this.

When there are no stop signs, yield signs or yellow diamond "right-of-way" signs at an intersection, then you must yield to the person on your right. These types of intersections are most common in residential areas. It is often difficult to know if someone is coming from the right unless you actively slow down and look carefully to your right before entering the intersection. It is important to do this though as cars coming from the right WILL expect you to yield.

There are a few more subtle aspects to this. You must yield right-of-way to a bus that is leaving a bus stop within city limits, but you do not have to do this outside city limits. Also, the yellow diamonds that regulate right-of-way are posted before the intersections they govern within city limits, but outside city limits the "right-of-way" starts after the intersection (and the sign is posted after the intersection) and continues through the next intersection, at which point it ends unless the signage repeats.

Other Differences of Note

Right turn on red. Many countries do not allow right turn on red. Where it is allowed, such as Poland, it is governed by a special right-arrow light at a traffic light. If the right arrow light is there and green, you can turn right on red after first coming to a full stop and then yielding to any other traffic. If there is no right arrow light, right on red is not allowed.

Traffic cameras. Many common traffic violations (speeding, going through red lights) are monitored by traffic cameras rather than patrol cars.

Speed limit signage. Speed limits in Europe are more complex. There are 3 areas where speeds are governed by "global limits" for that class of road: this is within built-up areas, on expressways and on motorways. If there is no explicit speedlimit in these areas, then the speedlimit is the national limit for that type of road. For example, in the Netherlands unless otherwise posted, the speed limits for a built-up areas is 50 km/h, an expressway is 100 km/h, and a motorway is 130 km/h. The key thing is unless otherwise posted. The European way is to "cancel" the previous explicit limit, which means the global limit for that class of road applies. Note also that each country has its own limits for these three classes of road, which, unhelpfully, is only posted when you first enter the country.

I'm not aware of any course in the US that teaches you all this. In practice, I think the most important thing to be aware of will be yielding to those on the right in residential areas. You can comfortably practice this around your own neighborhood in the US.

Do not pass on the right.

Learn the right of way rules.

Here is the US military driving manual for Germany. It comes the major rules and if followed will work for almost everywhere in Europe.
http://www.usareurpracticetest.com/germany/documents/manual.pdf

In some European countries there some things that are compulsory to carry in the car.
Check for each country you're visiting what's required.

Confirm what's provided by the hire co. and what you need to source.

Such things as first aid kits, fire extinguishers, Hi_vis jackets (one per person or driver only), disposable breathalyzer kits, spare bulbs, warning triangles (2 in Spain), snow chains (seasonal I guess).

Right-of-way rules are extremely important because everyone else drives as if you were going to respect them too, so it is easy to get into an accident by not knowing them. Other answers are covered this in great detail.

It is also important to know the default speed limits for the cities and between cities you will be travelling. The most puzzling sign I found in Denmark was a red circle with a bar over a number. This indicates that the shown number is no longer the speed limit. No units are specified but this number is in km/h instead of mph as in the US. The main point though is that the sign tells you what is not the speed limit but not the new limit. Instead, you return to be within the limit for the type of road and area (city-center, residential zone, intercity road) and, indeed you must know what that is.

Actual speed limit can be complicated. In Iceland, the sign is a matrix which I never managed to read entirely before passing! In one dimension, the type of vehicle is shown, in the other, the type road. The speed limit is the number, in km/h in the square which corresponds to your situation.

The wrong-way sign is a red circle with a white horizontal bar in it. This is seldom seen in the Americas.

Same for the no stopping and no parking ones:

Parking in Europe is vastly different from North America. The rules can be complex and local to some city zones too. In one place, I think it was Akureyri (IIRC), we had to buy a paper parking meter place in the car and manually indicate the marked time on it. Other places have sidewalk colors and I've many places where people parked partially on the sidewalk (although this might not have been legal). Going with the flow ensures you be no worse than the average but that won't make it legal in Europe. In contrast, California has laws that make following the flow a legal requirement in some cases!

While I visited 25 European countries, I have driven in 20 of them, relying on trains for the other 5, so I have a variety of experience driving, although based on so many less common rules, I'm sure to not have gotten everything 100% right. In the US, Canada, Ecador, Peru and Brazil, I have driven thousands of kilometres and the rules there a closer to those in Canada (Where I drove regularly for the best part of 30 years) and the US.