The Italian national road accident statistics show that for vulnerable road users (VRUs) urban areas are critical, since are the setting for 75% of accidents. In order to gain a detailed knowledge of the real severity of these accidents and the relationship between injuries and causes, it is necessary to gather in‐depth data of real‐world road accident injuries (i.e. typology, severity and causations). In this paper, 38 vehicle‐pedestrian and vehicle‐cyclist accidents in urban areas have been analysed from the InSAFE database. All the accidents involved at least one seriously injured person. Results are presented on pedestrian and cyclist:​ accident configurations, injury analysis, and impacts to injuries correlation. The analysis point out that primarily small and compact cars at an average impact‐speed of 40 km/h struck pedestrians and cyclists. Head was the most frequently injured body region with 28% and 54% of injuries respectively for pedestrians and cyclists. The most frequent head injury was epidural or extradural hematoma, principally caused by the impact against the A‐pillar and the upper frame of the windscreen. The results of the research are valuable to design next generation of in‐vehicle passive protective devices, specifically targeted for VRUs.