+3  A: 

Yes, you can certainly read and/or write an MDB as long as SQL server (or whatever) doesn't have the file locked. As far as I know, Microsoft has never documented the format of an MDB file, so you'll probably be on your own in trying to make sense of the contents though -- at a guess, it'll be decidedly non-trivial.

As to how to do the reading/writing, just about like a text file, except that you'll want to open it as a binary file. Where opening a text file would be something like:

FILE *file = fopen("myfile.txt");

For a binary file you'd use something like:

FILE *file = fopen("database.mdb", "rb+");

Realistically, I have to add that this answer, while correct, is probably useless. To get a meaningful answer, you probably need to ask about the format of a .mdb file (and to be sure of a meaningful answer, I'd probably specify the program you're talking about that produces the file, not just a file extension -- quite a few extensions are used by different programs for formats that are anywhere from subtly different to completely unrelated).

Jerry Coffin