More than 50% of detected pedestrian injuries were falls in the street or roadway, which may be missed if users of administrative data rely solely on pedestrian external cause codes for detection. Although on-street falls were more common in individuals aged 65 and older, they contributed to the burden of injury requiring emergency department visits across all age groups. Additionally, an increasing percentage of bicycling injuries were classified as ‘in-traffic’ but not resulting from motor vehicle collisions over the 15-year observation period Healthcare records offer a means to detect these injuries that are likely overlooked by police reporting.