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If you stay in St. George, perhaps a car is not necessary, you can walk or take a bus. St. George has a cheap and quite efficient scheduled bus service that visitors can use with no concerns about safety. Passengers pay $ 2 East Caribbean dollars (EC) per trip.
Having a car is advisable if you want to visit the whole island. The scenery is beautiful. You can stop at the beaches, the Anse coastline being one of the best. Keep in mind that cars run on the left side and most cars are right hand drive. If you rent a vehicle, you will have to buy a local driving permit. It costs US$12. The rental company will help you process that permit.
It can be hazardous to drive in Grenada because of the heavy traffic, cab driver's crazy driving of and the deteriorated condition of the roads. Roads, both paved and unpaved, often get damaged because of rains (the rainy season goes from June to November) and it takes a while before they are repaired.
The staff at the front desk of the hotels will help you if you prefer to know the island in a tour. It can be a good choice, it will take you a whole day.