Nighttime crashes at work zones are major concerns for construction workers and motorists. Although in a majority of the U.S. states, department of transportation specifications for work zone lighting mention that contractors should reduce glare for workers and drivers, only two states advocate detailed specifications like light positions, orientation, and light levels. Although some studies have examined the impact of glare from work zone lights on workers and others have calculated veiling luminance levels for drivers in the work zone, the effect of work zone lighting on drivers’ visual performance and glare perception has never been studied in a realistic setting. The goal of this study was to understand the impact of commercially available portable light towers (metal halide, LED, and balloon) and their orientation on drivers’ visual performance and their perceptions of glare. Participants drove through a realistic work zone simulated on the Virginia Smart Road. Visual performance was assessed by a detection task and perception of visibility and glare were assessed by questionnaires. Results indicated that the type of light tower and its orientation affect visual performance and perceptions of visibility and glare. Light towers aimed toward the driver resulted in lowering drivers’ visual performance, both objectively and subjectively. When the light towers were aimed away from or perpendicular to the driver, the visual performance was higher and the differences in visual performance between the types of light towers were minimal. These findings indicate that these orientations should be preferred for work zone light towers.