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This study aimed to clarify the relationship between truck-pedestrian crash impact velocity and the risks of serious injury and fatality to pedestrians. We used micro and macro truck-pedestrian accident data from the Japanese Institute for Traffic Accident Research and Data Analysis (ITARDA) database. We classified vehicle type into five categories: heavy-duty trucks (gross vehicle weight [GVW] ≥11 × 103 kg [11 tons (t)], medium-duty trucks (5 × 103 kg [5 t] ≤ GVW < 11 × 103 kg [11 t]), light-duty trucks (GVW <5 × 103 kg [5 t]), box vans, and sedans. The fatality risk was ≤5% for light-duty trucks, box vans, and sedans at impact velocities ≤ 30 km/h and for medium-duty trucks at impact velocities ≤20 km/h. The fatality risk was ≤10% for heavy-duty trucks at impact velocities ≤10 km/h. Thus, fatality risk appears strongly associated with vehicle class.