Context: That unconscious man on the road being taken into the ambulance was knocked down by a vehicle. The energy he absorbed from the impact was proportional to the weight of the vehicle with its occupants, and to the square of the velocity of the vehicle. That is a regular scenario for the most unprotected and the most vulnerable road user, the pedestrian. The need to know about him and protect him cannot be overemphasized. Objective: To determine the etiologies, severity of traumatic brain injuries and treatment outcome in pedestrians involved in road traffic accident. Methods: It was a prospective, cross-sectional study involving pedestrians with traumatic brain injuries from road traffic accidents managed in our center over a four year period. Data were collected using structured proforma which was component of our prospective data bank that was approved by our hospital research and ethics committee. The analysis was done using Environmental Performance Index (EPI) info 7 software. Result: Seventy three patients were studied. There were 48 males. The mean age was 25.08 years. Elderly patients were three. Fifty five patients had vehicular accident. Twenty two patients were injured between 6AM and 10AM. Thirty two patients had mild head injuries. Favorable functional outcome was seen in 82.19%, while mortality was 17.81%. Severity of injury significantly affected the outcome. Conclusion: Our study showed that the commonest cause of traumatic brain injuries in pedestrians was vehicular accident. The mortality from traumatic brain injuries among pedestrians was high. Severity of injury significantly affected the outcome.