Despite large investments in safer vehicles, roads and traffic safety programs, traffic accidents continue to impose huge costs to individuals and society. New approaches are needed to achieve ambitious traffic safety targets such as Vision Zero. A new traffic safety paradigm is changing how planning professionals measure traffic risks and evaluate potential safety strategies. It reflects recent research which improves our understanding of crash risks and potential traffic safety strategies. The old paradigm assumes that motor vehicle travel is overall very safe, and so applies targeted strategies which address specific risks. The new paradigm recognizes that all vehicle travel imposes risks, so planning decisions that increase vehicle travel tend to increase crashes, and vehicle travel reduction strategies increase traffic safety. It also recognizes that it is infeasible to reduce high-risk driving without providing viable alternatives. This expands the range of potential traffic safety strategies to include multi-modal planning, transportation demand management, and Smart Growth policies. A review of existing traffic safety programs indicates that most overlook or undervalue these new strategies.