Abstract Bicycles with integrated electric motors that require user effort, that is, pedal-assist e-bikes (PAEB), are increasing in popularity. There are several significant health benefits and benefits to our environment that can be attained by increasing use of PAEB. The purpose of this review was to synthesize the literature available on PAEB and to identify future directions for research, and policy and infrastructure development, that ensures an inclusive approach. We conducted a scoping review of the literature that led to the identification of 107 articles that included PAEB. Studies were grouped according to themes: Energy and Emissions, Bike Sharing, Violations and Accidents, Physical Activity, Active Commuting, and Perceptions. Overall, it appears that the uptake of PAEB leads to a modal shift such that overall car use is decreased. PAEB use is associated with lower emissions compared to cars, but requires physical effort that classifies use of a PAEB as moderate intensity physical activity. Cost appears to be prohibitive, thus sharing or rental programs, and subsidies may be beneficial. Several additional barriers related to lack of infrastructure were also noted. Importantly, violations, injuries, and crashes appear to be similar between PAEB users and traditional bicycle users. PAEB offer an opportunity to improve health and mobility in an eco-friendly manner compared to cars. Infrastructure and policies are needed to support this modal shift. There is an immediate need to clearly define PAEBs, and to ensure regulations are similar between PAEB and traditional bicycles. Future research is needed to better understand long-term behaviour change with regards to commuting, and to identify the effect of implementing better infrastructure and policies on PAEB uptake.

Highlights • A clear and consistent definition of PAEB is needed. • PAEB should be regulated similarly as traditional bicycles. • Use of PAEB is associated with lower energy and emissions. • PAEB riding is a form of moderate to vigorous intensity physical activity. • PAEB access can cause a significant modal shift.