The number of pedestrian-motor vehicle accidents and pedestrian deaths in China surged in recent years. However, a large scale empirical research on pedestrian traffic crashes in China is lacking. In this study, we identify significant risk factors associated with fault and severity in pedestrian-motor vehicle accidents. Risk factors in several different dimensions, including pedestrian, driver, vehicle, road and environmental factors, are considered. We analyze 6967 pedestrian traffic accident reports for the period 2006-2010 in Guangdong Province, China. These data, obtained from the Guangdong Provincial Security Department, are extracted from the Traffic Management Sector-Specific Incident Case Data Report. Pedestrian traffic crashes have a unique inevitability and particular high risk, due to pedestrians' fragility, slow movement and lack of lighting equipment. The empirical analysis of the present study has the following policy implications. First, traffic crashes in which pedestrians are at fault are more likely to cause serious injuries or death, suggesting that relevant agencies should pay attention to measures that prevent pedestrians from violating traffic rules. Second, both the attention to elderly pedestrians, male and experienced drivers, the penalty to drunk driving, speeding, driving without a driver's license and other violation behaviors should be strengthened. Third, vehicle safety inspections and safety training sessions for truck drivers should be reinforced. Fourth, improving the road conditions and road lighting at night are important measures in reducing the probability of accident casualties. Fifth, specific road safety campaigns in rural areas, and education programs especially for young children and teens should be developed and promoted. Moreover, we reveal a country-specific factor, hukou, which has significant effect on the severity in pedestrian accidents due to the discrepancy in the level of social insurance/security, suggesting that equal social security level among urban and rural people should be set up. In addition, establishing a comprehensive liability distribution system for non-urban areas and roadways will be conducive to both pedestrians' and drivers' voluntary compliance with traffic rules.