Accidentally killing or feeling responsible for another person’s death constitutes a traumatic event that is unique from any other traumatic stressor. Considering the frequency of incidents such as deaths resulting from road traffic accidents (RTAs), it is surprising that the academic literature regarding those who have accidentally killed is almost none existent. This study therefore aimed to gain an insight into the lived experiences of drivers who have caused an accidental death. Five participants were recruited through an on-line advertisement; all were drivers directly involved in a RTA that occurred suddenly, unexpectedly, without planning or intention and resulted in the death of a person. An interpretative phenomenological approach was used to analyse data collected through semistructured interviews. Three main themes emerged from the participants’ accounts: trying to make sense of a life changing moment; struggling to cope with the trauma of causing a death and a changed sense of self. These findings are discussed in relation to the relevant literature. Clinical implications, methodological limitations and directions for future research are presented. The study provides a valuable insight for any professional working with people who have caused, or feel responsible for, an accidental death. It is hoped that this study will be a catalyst for discussion and future research.