Civil engineering structures such as grandstands, slabs, footbridges and staircases have reported unacceptable vertical vibration when they are affected by human activities. Even when most of these structures are designed according to current guidelines and design codes, there are still misunderstandings in the human-structure interaction effects that, in some cases, may increase the vibration response compromising the structural serviceability performance. As a result, the serviceability load conditions due to pedestrian activities control, in most cases, the design for these structures. Therefore, a systematic overview regarding vertical pedestrian-structure interaction is carried out to demonstrate the need for a realistic analysis to properly incorporate these effects toward more rational structural designs. The discussion establishes a body of knowledge regarding pedestrian loads and structural responses, yielding the potential for more rational approaches to improving the analysis and design of pedestrian structures.