A five-year U.S. study of 1,000 marked crosswalks and 1,000 unmarked comparison sites found that on most roads, the difference in safety performance of marked and unmarked crossings is not statistically significant, unless additional safety features are used. On multilane roads carrying over 12,000 vehicles per day, a marked crosswalk is likely to have worse safety performance than an otherwise similar unmarked location, unless safety features such as raised median refuges or pedestrian beacons are also installed. On multilane roads carrying over 15,000 vehicles per day, a marked crosswalk is likely to have worse safety performance than an unmarked location, even if raised median refuges are provided. The marking pattern had no significant effect on safety. This study only included locations where vehicle traffic was not controlled by a signal or stop sign.