The Crash Injury Research Engineering Network, CIREN, was initiated by NHTSA as a collaborative forum for detailed investigation of motor vehicle crashes. This arrangement brings together experts from medicine, academia, industry, and government to perform detailed analyses of the injuries sustained in specific collision modes. The CIREN program has typically focused on vehicle occupants, but in 2002 the Honda Inova Fairfax Hospital CIREN Center established a special program for pedestrian crash investigations. The goal of the center has been to – complete detailed crash investigations for impacts between a pedestrian and a passenger car or light truck. Detailed medical and anthropometric data are collected at the level one trauma center and expert investigations of the vehicle and crash scene are conducted. Multi-body simulation models are sometimes used to estimate impact kinematics for the pedestrian and to validate vehicle speed estimations and initial position of the pedestrian. An interdisciplinary team analyzes the data and develops a consensus for the most likely impact scenario and injury mechanisms. This paper presents our initial experience from investigating over twenty pedestrian collisions. We will discuss the challenges associated with collecting and analyzing this data as well as initial observation of injury trends and mechanisms encountered.