PURPOSES : The fundamental diagram provides basic information necessary in the analysis of traffic flow and highway operation. When traffic flow is congested, the density-flow points in the fundamental diagram are widely scattered and move in a stochastic manner. This paper investigates the pattern of density-flow point transitions and identifies car-following behaviors underlying the density-flow transitions. METHODS : From a microscopic analysis of 722 fundamental diagrams of NGSIM data, a total of 20 transition patterns of fundamental diagrams are identified. Prominent features of the transition patterns are explained by the behavior of the leader and follower. RESULTS : It is found out that the average speed and the speed difference between the leader and the follower critically determine the density-flow transition pattern. The density-flow path is very sensitive to the values of vehicle speed and spacing especially at low speed and high density such that most fluctuations in the fundamental diagram in the congested regime is due to the noise of speed and spacing variations. CONCLUSIONS : The result of this study suggests that the average speed, the speed difference between the leader and the follower, and the random variations of speed and spacing are dominant factors that explain the transition patterns of a fundamental diagram.