OBJECTIVE Problems facing authorities and researchers of road traffic accidents in most developing countries include lack of data and clarity and accessibility problems with existing data. This resulted in a severe scarcity in information on pedestrian crashes, which, in turn, served as an obstacle facing all efforts to reduce these crashes. This study aims at studying pedestrian crashes with regard to their causes and characteristics in Riyadh, analyzing the bodily distribution of injuries in victims and determining the characteristics of pedestrians and drivers involved in these collisions. METHODS Data on randomly selected road traffic accidents involving pedestrians between July 2005 and June 2008 were collected from five different sources. Data collected included date and location, casualty details, accident sketch, weather conditions, site characteristics, road surface conditions, vehicle characteristics, type of collision, vehicle(s) direction and movement, damage description, and causes as well as details of parties involved such as nationality, age, education level, severity of injury, and others. RESULTS The number of pedestrian crashes investigated was 460, involving 551 victims over a 3-year period (out of an estimated 1500 crashes). Results showed that the average rate of pedestrian fatalities per accident was as high as 0.32 and that almost two thirds of drivers and slightly less than half of the victims were less than 30 years of age. In contrast to other road traffic accidents (RTAs) in this city, two thirds of pedestrian crashes occurred between 4:00 pm and midnight. Results also revealed that non-Saudis and men were at a significantly greater risk than Saudis and women to be involved in pedestrian crashes. It was also found that two thirds of pedestrians involved in RTAs were struck while crossing the road. Moreover, although 8.7 percent of Riyadh's population lives in the southern and northern regions of the city, pedestrian crashes in these two regions constituted 32.2 percent of all pedestrian crashes. As related to injury type, head, thorax, and spinal injuries formed most of the serious injuries. It was also found that the most often injured body regions were the upper and lower extremities and the head. CONCLUSIONS Practical recommendations are given that researchers, traffic police, medical authorities, nongovernmental organizations (NGOs), educational institutions, and municipalities can adopt to lower the risk of pedestrian crashes.