Similar to the nationwide trend of declining pedestrian safety, pedestrian fatalities in Tennessee increased by 117 % between 2009 and 2019. During the same time, pedestrians involved in traffic crashes have only increased by 26 %, suggesting that the reason for the increased number of fatalities is that pedestrian crashes are becoming more severe. The media, and safety advocates speculate about the different scenarios that could be responsible for the decrease in pedestrian safety. Past studies have failed to integrate pedestrian involvement into their studies and confirm whether pedestrian crashes are becoming more severe. Our study collected all reported pedestrian crashes and their outcomes from crash data kept by the Tennessee police, thus providing fatality and involvement numbers. Excluding crashes on controlled access roads, we measured the pedestrian fatality rate (PFR) for essential variables for each year from 2009 to 2019. An upward PFR graph shows that pedestrian crashes are becoming more severe compared with the past. To substantiate our claims with adequate statistical significance, we employed separate Poisson regression models for the pedestrian fatality count and PFR associated with each attribute of pedestrian crashes. The results show that an increase in severity is linked with multilane urban arterials with speeds above 35 mph at midblock locations. The study results also confirm that cars are still the cause of the high fatality rate in Tennessee rather than sport utility vehicles or other large vehicles. We recommend that cities reduce design speeds to 35 mph, increase safe pedestrian crossing opportunities, and install more pedestrian-scale lighting infrastructure on urban arterials.