Background: Golf is enjoyed by over 108 million people globally, and has established elite female, male and disability competitive schedules. The use of golf carts during elite competition is a topic of discussion regarding the principles of inclusivity and competitive fairness with important scientific, legal and ethical considerations. Objective: The primary aim was to evaluate the evidence relating to riding a golf cart in comparison to walking the golf course, pertaining specifically to: (1) inclusivity and safety, and (2) competitive fairness. The secondary aim was to identify knowledge gaps and research priorities. Methods: We conducted a scoping review and the search strategy was applied to the following databases, and articles were extracted by independent reviewers from PubMed, Web of Science, Scopus and ProQuest Central. Grey literature was examined using Google Advanced Search. A five-stage scoping review methodology followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Articles were collated using an online tool (Covidence) and evaluated against pre-determined criteria. Data from included studies were collated to facilitate descriptive and thematic analysis. Results: Of the 879 studies identified, 72 were included for analysis. Seven themes emerged: physical demands, inclusion and accessibility, cognitive demands, legal and ethical, nutrition and hydration, competitive fairness, and safety and injury risk. Golf carts promote accessibility, particularly for individuals with disabilities. Safety concerns predominantly arise in non-elite settings, with incidents linked to operator error, poor safety governance and use on public highways. There is compelling evidence demonstrating that in-round riding of golf carts reduces the physical demands of golf, with users expending less energy and covering shorter distances, although effects on performance is uncertain. Golf cart use may mitigate the environmental aspects of golf, including the effects of hot/humid weather or hilly topography. Conclusions: Golf carts can increase inclusivity for golfers and enable clubs and organisations to meet their ethical and legal requirements around accessibility. However, riding golf carts may diminish some of the health benefits of golf, and present a risk of injury and practical challenges. In the competitive setting, golf cart use reduces the physical demands of the game, affecting the environmental challenges of variable weather and terrain. It is biologically plausible and likely that this would offer a performance advantage in some circumstances. More research is needed to guide the fair use of this enabling technology within clearly defined contexts by: (1) evaluating the performance deficits associated with medical issues in which the use of golf carts might be considered permissible, and (2) evaluating the magnitude and nature of competitive advantages experienced by golf cart riders. Key Points: Golf carts support greater accessibility by allowing individuals with mobility limitations to engage in the sport. Although the safety concerns related to golf cart use are well established, they largely pertain to recreational settings rather than elite or professional competition environments. Riding a golf cart lessens the physical demands of play, helps manage fatigue and reduces environmental strain. This may mitigate the effects of disability associated with some medical conditions (performance enabling), but in some circumstances could provide an additional advantage (performance enhancing). Evidence-informed and consistently applied policies are essential to ensure both inclusivity and fairness in competition, particularly for athletes requesting medical exemptions.
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