Pedestrian injuries vary according to vehicle type, position during the accident, and pedestrian’s age, thus determining complex aspects by associating multiple types of traumas. In forensic practice, it should be noted that the lesion-producing mechanisms recorded among pedestrians are most frequently mixed, reason for which a correct and careful examination of the victim must be supported by the characteristics of the vehicle involved in the accident, as well as by other elements at the crime scene. It is necessary to thoroughly examine the injuries, an analysis that should always be characterized by a dynamic interpretation, directly related to the mechanism of accident occurrence, with case-by-case individualization, to result in the clarification of conditions difficult to grasp at a superficial interpretation. This article aims to briefly review the main lesion mechanisms in case of pedestrians, to emphasize on the importance of understanding the complexity of these injuries, in order to elucidate – as accurately as possible – the circumstances of such an ill-fated event.