In a literature review and analysis of accident statistics it has been found that older pedestrians in many ways are a disadvantageous group of road users. They have increased accident risk and are more vulnerable to injuries. They also suffer more serious and long-lasting impairments when injured, including reduced life expectancy and reduced quality of life. Safety and mobility are closely related. Physical activity is related to reduced risk of accidents and severity of injuries. High accident risk in road traffic is often associated with reduced walking. Safety measures are most promising when they increase physical activity, e.g. by physical and motivational training, by providing practical aids, and by making pedestrian infrastructure less complex, less demanding and more attractive. Addressing specific functional impairments seems less promising.