Daily walking is a recommended physical activity. It can be an all-age suitable, environment-friendly transport option. However, traffic crashes are a widely recognized risk factor, associated with drivers’ errors or a combination of several environmental factors, including physical characteristics of the road space. The aim of this study was to assess the characteristics of built environments on pedestrian safety. Data on road accidents that had occurred between 2005 and 2015, in Alghero, Italy, were retrieved and matched with spatial and functional street qualities. On-street parking was found to increase the risk of pedestrian accidents by about two times, whereas, narrow travel lanes and intersections reduced the incidence of crashes and their public relevance. These field results could inform urban health and spatial planning policies with the final goal of improving health and providing more sustainable models of urban organization.