The Pickup and Delivery Problem with Time Windows (PDPTW) involves optimizing routes for vehicles to meet pickup and delivery requests within specific time constraints, a challenge commonly faced in logistics and transportation. Microtransit, a flexible and demand-responsive service using smaller vehicles within defined zones, can be effectively modeled as a PDPTW. Yet, the need for driver breaks—a key human constraint—is frequently overlooked in PDPTW solutions, despite being necessary for regulatory compliance. This study presents a novel mixed-integer linear programming formulation for the Pickup and Delivery Problem with Time Windows and Driver Breaks (PDPTW-DB). To the best of our knowledge this formulation is the first to consider mandatory periodic driver breaks within optimized Microtransit routes. The proposed model incorporates regulatory compliant break scheduling directly within the vehicle routing optimization framework. By considering driver break requirements as an integral component of the optimization process, rather than as a post-processing step, the model enables the generation of routes that respect hours of service regulations while minimizing operational costs. This integrated approach facilitates the generation of schedules that are operationally efficient and prioritize driver welfare through driver breaks. We work with a public transit agency from the southern USA, and highlight the specific nuances of driver break optimization, and present a Pickup and Delivery Problem with Time Windows formulation for optimizing Microtransit operations and scheduling driver breaks. We validate our approach using real-world data from the transit agency. Our results validate our formulation in producing cost-effective, and regulation-compliant solutions.