The increasing use of heavy vehicles for services such as public transport, waste collection and logistics in densely populated urban areas causes numerous collisions with serious consequences every year, particularly for pedestrians, cyclists and motorcyclists. Advanced Driver Assistance Systems (ADAS) have proven to be a solution because they can significantly reduce the occurrence and consequences of road crashes. Although many ADAS technologies will be mandatory on new trucks in 2024, it will take more than a decade before the benefits are realised due to the average fleet renewal time. To accelerate this process, the most promising solution is therefore the introduction of aftermarket ADAS (also referred to as ‘retrofit’ ADAS) on the circulating fleet. This study aims to identify a tailored solution for retrofitting ADAS capable of providing pedestrian collision warnings on heavy vehicle fleets currently circulating in urban areas. The study involves a sample of vehicles and drivers operating in the metropolitan areas of Florence and Pistoia for waste collection services. The company owner of the vehicles integrated a commercial camera-based ADAS system with three additional cameras installed on the frontal bumper and edges of the vehicle, linked with three screens positioned in the vehicle cabin. In this study, a field test campaign was performed integrating trials in a proving ground closed to traffic with testing and monitoring in urban areas. This allowed to define a set of recommended parameters depending on vehicle speed that represent a good balance between alert frequency, minimizing false positives and ensuring that the alerts indicate real potential hazards to the driver. The recommendations provided in this study can also be extended to other vehicle fleets so that rapid and substantial improvements in the safety of heavy vehicles operating in cities can be achieved.