All pedestrian vehicle collision fatalities to children less than five years of age in Washington State were evaluated for a five-year period using State death certificates, coroners' reports, and police records. Although the majority of pedestrian fatalities to older children have been shown to be due to "dart-outs" into traffic with the child being struck by an oncoming car, pedestrian fatality incident for children less than five tended to occur when the child was backed over in the home driveway by the family van or light truck driven by a parent. Prevention of pedestrian injuries in this age group requires strategies aimed at safeguarding the driveway and reassessing the safety of light trucks and vans as family vehicles.