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Texas District Judge Keith Dean jailed Frank Dorsett for a year, and ordered that he must then drive a low-powered car and carry a photo of the wreck he helped to cause outside Dallas in June 2003.
He must also take daily medication that will make him sick if he drinks alcohol, and carry a bumper sticker asking other motorists to call the probation department if he drives recklessly.
Dorsett was racing another driver along a highway when the other man hit and killed a 16-year-old girl in a third car.
Judge Dean was not satisfied with a jury's decision that Dorsett should face only probation.
The parents of Rachel Blasingame, the victim, praised the unusual sentence.
"We feel the terms of his probation will make up for anything the jury had taken away from us," said her father, Guy Blasingame.
Jason T Scott, the other driver involved in the chase, is awaiting trial.