The relative importance of pedestrian accidents as a source of road accident trauma is shown by reference to national and international data. The methodology of pedestrian accident investigation at Birmingham University is presented and the results of a recent study used to describe the general characteristics of pedestrian accidents. The pattern of injury sustained by pedestrians struck by the fronts of cars is described and the nature, cause and severity of leg injuries and head injuries considered in detail. The implications of bumper location are discussed. The importance of the windscreen frame as a source of serious head trauma is demonstrated.