There are several similarities in blunt trauma injuries to humans sustained as a result of vertical deceleration (falling) and those sustained as a result of deceleration in a horizontal plane (automobile accidents). However, examination of the patterns of traumatic skeletal injuries can differentiate between the two. This study reviews both the current literature and human skeletal remains known to have been subjected to blunt trauma. The collection is used to characterize and differentiate the patterns and applies the assessments to investigate the traumatic skeletal lesions observed in a forensic case where the manner of death was unknown. Analyses suggested two possible scenarios that would explain the individual’s death, with death most likely related to a vehicular-pedestrian accident. The presence of injuries to relatively rarely fractured bones (scapula and first-ribs) suggested a wide, blunt trauma of extreme force. These injuries and the pattern of injuries to the thoracic region of the individual was most consistent with vehicular trauma, most likely a truck striking a pedestrian from behind, on the left side. Figures, references