I don't think it is a US thing only. For normal cars here (Italy) inspection is first time after 4 years and then every 2 years. Once (but frequency of inspec

I don't think it is a US thing only. For normal cars here (Italy) inspection is first time after 4 years and then every 2 years. Once (but frequency of inspections was lower if I recall correctly) you could only have it inspected by the equivalent of the DMV, since several years there are authorized (private) workshop/mechanics that can do it, so the process is much easier/faster than before and you have the possibility to choose among many different places to go and it is usually a matter of a few days at most to get an appointment. For some kind of papers/authorizations (as an example to add a trailer to your car or if you import a car from another country) you still need to actually go to the government offices, and here - usually - the troubles start, appointments only available after several months, long queues anyway, even minor issues with the documentation resulting in stopping the procedure and needing a new appointment, a nightmare. Recently a friend bought a new car and needed to have the modifications for his disabilities (made by a specialized, authorized workshop) inspected and approved, it took him (actually to the workshop, that AFAICU has even some advantages in the queuing system) almost four months to get the vehicle inspected and approved.