In many places, roads are constructed without considering children, though many children use the roads as pedestrians, bicyclists, motorcyclists and occupants of vehicles. They may live close to a road, play on a road, or even work on the roads selling merchandise, weaving in and out of moving traffic.

Disabilities and impairments can hinder the progress of children in their early years holding them from education and social development. Children who sustain disabilities following a road traffic crash frequently require long-term care and their quality of life is often poor. The excessive strain placed on families who have to care for their injured children may result in adults having to leave their jobs, leading to conditions of poverty.

Globally, over 700 children die each day due to road traffic injury. Road traffic injuries are the leading cause of death among young people aged 15 to 19 years and the second leading cause among 5-14-year-olds.

Road traffic fatality rates increase with age, reflecting the way children of different ages use the road. Children up to the age of nine years are more likely to be accompanied by parents when they travel, either in vehicles or as pedestrians, while older children tend to travel more independently, initially as pedestrians and later as cyclists, motorcyclists and finally drivers. The higher rates of injury among children aged 10 years and over is a result of this increased mobility as well as their increased tendency to exhibit risk-taking behaviours.

In many countries, children are taught to ride bicycles as a form of recreation and in many parts of Asia, bicycles are also a common means of transport. This is reflected in the statistics. Cyclists constitute 3%-15% of children injured in traffic collisions and 2%-8% of child traffic-related fatalities around the world. Where motorcycles are commonly family vehicles, children may begin to travel on motorcycles at an early age, either sitting on the petrol tank or behind the driver. Globally, pedestrians form the single largest category of children involved in road traffic crashes. In high-income countries between 5% and 10% of children suffering road traffic injuries are pedestrians, while in low-income and middle-income countries the proportion ranges from 30% to 40%. Child pedestrian injury is highest in Africa and Asia where it is usual for people to walk along roads.

A child is physically more vulnerable to injury than an adult. Furthermore, the smaller physical stature of children can create problems, as it limits their ability to see or be seen. Children's senses are also less developed and their ability to analyse information from their vision and their hearing is limited, also increasing the number of dangerous situations. A certain amount of risk-taking is a normal expected behaviour and is necessary for a child's development, so it is the responsibility of adults to understand the children's limitations and vulnerability in the road environment, and to ensure their safety.

Traditionally, road safety for children has focused on road safety education with the assumption that children must be taught how to adapt their behaviour. However, when used in isolation, education does not deliver permanent reductions in traffic deaths and serious injuries. The SafeSystem approach has proved valuable in delivering greater road safety for children. It moves away from the idea that children should adapt their behaviour to cope with traffic, in favour of an approach in which children's needs are addressed in the design and management of the whole road system. Large gains can be made in terms of injuries avoided and lives saved if effective strategies commonly used in high-income countries are adapted to the context of low-income and middle-income countries where children are at considerably higher risk.

The World Health Organization's publication, Ten strategies for keeping children safe on the road (2015) is a valuable resource containing a few of the most effective interventions for road safety and the safety of children.