In some states like PA or WV, there are yearly or every other yearly inspections, but all they do is check tire tread depth basically. You could pass with a blown strut, oil leak, bad alignment, mismatched tires (as long as they have enough tread), duct taped body panels, etc. In other states, you ONLY get a car inspected upon purchase. In MD this is how they do it, and there is nothing stopping anyone from driving on 100% bald tires, or with any other major problems. It's ridiculous.