Most pedestrian crashes happen while the pedestrian is attempting to cross the road. Crossing a busy road with fast flowing traffic can be very difficult.

Pedestrian refuge islands can help pedestrians to cross such roads safely. They can be used where there is a demand for pedestrians to cross the road, but where the numbers of pedestrians are not high enough to warrant a signalised pedestrian crossing.

Pedestrian refuge islands are raised median islands that provide a location for pedestrians to safely wait for a gap in the traffic so they can finish crossing the road. This makes crossing the road easier for pedestrians by allowing them to cross in two stages and deal with one direction of traffic flow at a time.

Pedestrian refuge islands should ideally be at least 1.8 metres wide (narrow refuge islands put pedestrians at risk of being hit by truck side mirrors) and can be part of an unsignalised pedestrian crossing. A width of at least 2.4m will further facilitate usage by wheelchair users.

Refuge islands alone are usually inadequate on wide, multi-lane roads. They can be helpful where pedestrian crossings would result in traffic congestion. In these circumstances, crossings should be signalised. Otherwise, adequate safe gaps should be available in conjunction with traffic calming to reduce approach speeds. It will also be desirable to stagger the pedestrian crossings on each side of the central refuge island such that pedestrians will naturally look towards approach traffic.

Traffic islands at intersections can also act as refuge islands (especially to assist in movement across the minor road), and provide additional safety benefit at these locations.