In Finland, all fatal on-road and off-road motor vehicle crashes are subject to an in-depth investigation coordinated by the Finnish Crash Data Institute (OTI). This study presents an exploratory and two-step cluster analysis of fatal pedestrian crashes between 2010 and 2019 that were subject to in-depth investigations. In total, 281 investigations occurred across Finland between 2010 and 2019. The highest number of cases were recorded in the Uusimaa region, including Helsinki, representing 26.4% of cases. Females (48.0%) were involved in fewer cases than males; however, older females represented the most commonly injured demographic. A unique element to the patterns of injury in this study is the seasonal effects, with the highest proportion of crashes investigated in winter and autumn. Cluster analysis identified four unique clusters. Clusters were characterised by crashes involving older pedestrians crossing in low-speed environments, crashes in higher speed environments away from pedestrian crossings, crashes on private roads or in parking facilities, and crashes involving intoxicated pedestrians. The most common recommendations from the investigation teams to improve safety were signalisation and infrastructure upgrades of pedestrian crossings, improvements to street lighting, advanced driver assistance (ADAS) technologies, and increased emphasis on driver behaviour and training. The findings highlight road safety issues that need to be addressed to reduce pedestrian trauma in Finland, including provision of safer crossing facilities for elderly pedestrians, improvements to parking and shared facilities, and addressing issues of intoxicated pedestrians. Efforts to remedy these key issues will further Finland’s progression towards meeting Vision Zero targets while creating a safer and sustainable urban environment in line with the United Nations sustainable development goals.