Pedestrian injuries and deaths should be viewed as a critical public health issue. The purpose of this chapter is to show how incorporating safety from traffic into broader efforts to increase walking and physical activity has the potential to have a significant health impact. In this chapter we provide an overview of pedestrian safety considerations having to do with population health and the built environment. The chapter is organised around a conceptual framework that highlights the multiple pathways through which safe walking environments can contribute to improved population health. We review the existing literature on pedestrian safety and public health. Pedestrian safety will remain a vexing challenge for public health and transportation professionals in the coming decades. But addressing this problem on multiple fronts and across multiple sectors is necessary to reduce injuries and fatalities and to unleash the full potential of walking to improve population health through increased physical activity. This chapter uniquely contributes a conceptual framework for understanding the relationship between the walking environment and public health.