This paper describes a study carried out to develop and apply computer analysis tools to simulate real-world accidents between vehicles and pedestrians. The main focus has been the incorporation of realistic pedestrian pre-impact gait motion and to investigate the outcome of real-world impacts. A combination of multi-body, FACET and finite element based vehicle models in conjunction with validated human body models developed by MADYMO were used to simulate and analyse vehicle–pedestrian accident scenarios. European regulations and consumer tests for passenger cars now address vehicle front aggressiveness, and vehicle manufactures have effectively developed design solutions for meeting these requirements. Vehicle frontal geometry and pedestrian pre-impact characteristics play a major role in determining the post-impact kinematics and severity of injury sustained during pedestrian–vehicle contact stage. A unique aspect of this study has been the application of the Injury Severity Index method developed for automotive occupant injury assessment to pedestrians. The injury results from the simulations were measured and the severity assessed by applying a quantitative rating method.