: The incidence of pedestrian traffic injuries is an escalating concern for public health worldwide. Particularly in fast-developing nations, such as Saudi Arabia, these injuries form a significant portion of trauma-related healthcare challenges. This study aims to explore age-specific differences in trends, seasonal variations, and the overall impact of pedestrian traffic injuries in Riyadh, Saudi Arabia, with a focus on injury characteristics and clinical outcomes. : The study conducted a retrospective analysis using data from the Saudi Trauma Registry (STAR) covering the period between August 2017 and December 2022. It employed descriptive statistics, chi-square tests, and multivariable linear regression analyses to explore demographic trends, characteristics of injuries, and hospital-based outcomes. : This study analyzed data from 1062 pedestrian injury cases, revealing key demographic and clinical patterns. Most incidents occurred on weekdays (71.9%) and during nighttime hours (63.3%), with seasonal peaks observed from April to June (30.4%). The lower extremities (27.5%) and head (21.3%) were the most frequently injured body regions. ICU admissions were more common among individuals aged 30-40, females, and those with head or chest trauma, while higher in-hospital mortality was associated with patients over 60 years old, transport by private or police vehicles, and extended ICU and hospital stays. Approximately 25.6% of cases required ICU care, with an overall in-hospital mortality rate of 4.9%. : This study provides an in-depth analysis of pedestrian traffic injuries treated at a trauma center in Riyadh, highlighting significant demographic, temporal, and clinical patterns. Understanding these trends is essential for optimizing resource allocation and improving emergency care outcomes. Furthermore, the identified age-specific risk factors and seasonal variations underscore the critical need for targeted interventions and policy enhancements to improve road safety and reduce the burden of pedestrian injuries.