Pedestrian infrastructure plays a critical role in facilitating first-/last-mile access to transit. Efforts to connect pedestrians to transit through infrastructure improvements, however, often face considerable implementation barriers. These barriers can be particularly pronounced for suburban transit providers, which serve low-density, automobile-oriented development and often must coordinate across many jurisdictions. In this analysis, we examine strategies that transit agencies, metropolitan planning organizations, and municipalities use to build pedestrian infrastructure near suburban transit services in the United States, and the barriers they face in this process. We use Pace Suburban Bus, a transit provider in the Chicago, Illinois region, as an illustrative case study, conducting surveys with planners and interviews with diverse stakeholder groups in the agency’s service area. To complement these findings, we conduct an online survey of similar agency types in ten peer regions across the United States. The results suggest that agencies support pedestrian access to transit through a variety of plans, policies, programs, and partnerships. However, agencies face significant implementation barriers, including limited funding, competing investment priorities, jurisdictional/coordination issues, automobile-oriented planning and development, regulatory compliance issues, and limited staff capacity. Based on these findings, we propose recommendations related to planning (e.g., better inclusion/documentation of pedestrian needs in plans), policy (e.g., regional support for Complete Streets and Americans with Disability Act related policy efforts), funding (e.g., regional platforms for sharing funding opportunities), and education (e.g., staff training and community awareness campaigns). These recommendations provide specific actions that agencies at multiple levels of government can take to better support pedestrian access to transit in suburban communities.