The World Health Organization (WHO) has identified that developing countries are more prone to road traffic fatalities, and Pakistan is no exception. WHO says that almost half of the world’s annual road traffic fatalities of approximately 1.3 million people are pedestrians, cyclists, and motorcyclists, and more than 90% happen in developing countries. Reasons for this include the increasing use of motorized vehicles, and the absence of pedestrian-friendly policies on national and local levels (Leather et al. in Walkability and Pedestrian Facilities in Asian Cities State and Issues. Metro Manila: Asian Development Bank, 2011). With a focus on building roads, idealizing the car as a status symbol, and a lack of pedestrian-focused planning policy, in Pakistan’s largest metropolitan city, pedestrians are increasingly becoming vulnerable on the roads (Hasan and Raza 2015). This paper examines available data on motorization and pedestrian deaths in Karachi as a symptom of poor walkability infrastructure and an absence of pedestrians in the planning policy. The paper also analyzes secondary and primary data to examine fatalities in road traffic accidents (RTAs) in Karachi and the role of walkability infrastructure and motorization in increasing the number of accidents. The study also looks at the existence or lack of engineering interventions to prevent road traffic accidents, based on observations and photographic evidence from the different localities across Karachi. This paper establishes vehicle-centric policies and poor walkability infrastructure as causes of fatalities in RTAs. It considers RTAs preventable with correct planning and design decisions by putting the pedestrian in policy. This study of mortalities caused by RTAs and poor walkability is useful for planners, decision-makers, and road users.