This study tests the hypothesis that most pedestrian collisions occur near victims' homes. Patients involved in automobile versus pedestrian collisions who presented to the emergency department at a Level I trauma center between January 2000 and December 2009 were included in the study. Patient demographics were obtained from the trauma registry. Home address was determined from hospital records, collision site was determined from the paramedic run sheet, and the shortest walking distance between the collision site and pedestrian residence was determined using Google Maps. We summarized distances for groups with the median and compared groups using the Kruskal-Wallis rank test. We identified 1917 pedestrian injury cases and identified both residence address and collision location for 1213 cases (63%). Forty-eight percent of the collisions were near home (within 1.1 km, 95% CI 45-51%). Median distance from residence to collision site was 1.4 km (interquartile range 0.3-7.4 km). For ages 0-17, the median distance 0.7 km, and 59% (95% CI 54-63%) of collisions occurred near home. For ages 65 and older, the median distance was 0.6 km and 65% (95% CI 55-73%) were injured near home. Distance did not differ by sex, race, ethnicity, or blood alcohol level. More severe injuries (Injury Severity Score ≥ 16) occurred further from home than less severe injuries (median 1.9 km vs. 1.3 km, p=.01). Patients with a hospital stay of 3 days or less were injured closer to home (median 1.3 km) than patients with a hospital stay of 4 days or more (median 1.8 km, p=.001). Twenty-two percent were injured within the same census tract as their home, 22% on the boundary of their home census tract, and 55% in a different census tract.