This report describes the range of design exception practices among state transportation agencies (STAs) and discusses the problems and suggested improvements based on the experience of state agency personnel. All STAs are required to comply with the same federal regulation pertaining to design exceptions. However, the number of design exceptions, the circumstances under which they are prepared, and the methods employed vary considerably, with many factors contributing to this wide range of practice. This synthesis characterizes (1) conditions that require a design exception, (2) data collection and analysis techniques, and (3) internal STA and external rules. The report also describes benefits and problems experienced by STAs and identifies suggestions for improving and streamlining the design exception process. In addition, the innovative practices of two states (New Jersey and Wisconsin) are identified and discussed.