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This study aimed at prediction of long bone fractures and assessment of lower extremity injury mechanisms in real world passenger car to pedestrian collision. For this purpose, two pedestrian accident cases with detail recorded lower limb injuries were reconstructed via combining MBS (Multi-body system) and FE (Finite element) methods. The code of PC Crash was used to determine the boundary conditions before collision, and then MBS models were used to reproduce the pedestrian kinematics and injuries during crash. Furthermore, a validated lower limb FE model was chosen to conduct reconstruction of injuries and prediction of long bone fracture via physical parameters of von Mises stress and bending moment. The injury outcomes from simulations were compared with hospital recorded injury data and the same long bone fracture patterns and positions can be observed. Moreover, the calculated long bone fracture tolerance corresponded to the outcome from cadaver tests. The result shows that FE model is capable to reproduce the dynamic injury process and is an effective tool to predict the risk of long bone fractures.