The study set out to compare crash and injury patterns of Vulnerable Road Users across a number of different countries and databases to illustrate relative outcomes in different regions. Several analyses of crash and casualty crash patterns were undertaken using real-world crash databases from a number of different countries. The factors examined included the type of vulnerable road user, the vehicle involved, the primary crash cause, age of the road user, injury outcome (fatal or casualty), crash location and single or multi-vehicle collision. The findings from this study highlighted emerging and severe road crash problems for society currently not being addressed in existing safety initiatives by governments or vehicle manufacturers in these regions. A number of potential solutions to these problems including engineering countermeasures for vehicles and road infrastructure, greater use of protective equipment for riders, enhanced police enforcement efforts and technologies, and improved training and licensing practices. Public policy response to this growing epidemic in developing countries has been muted at national and international levels and policy makers need to recognise this growing problem as a public health crisis and design appropriate policy responses. With growing usage of VRU transport in developing countries, this burden is expected to become even larger in the years ahead in these regions without urgent attention.