Off-road bicycle racing has shown rapid growth in participation during the past 10 years. Although no comprehensive studies have yet been conducted regarding the medical aspects of participation at all levels of the sport, limited data obtained from the Pro/Elite category of NORBA have provided some useful information. The majority of injuries sustained by this group were wounds and contusions. In addition, the lower extremities accounted for a majority of the injuries seen, with the exception of the low back region, which had the highest incidence of injury for the female cyclists in the present study. The absence of catastrophic head/neck-related injuries lends support to the premise that at the Pro/Elite level off-road bicycle racing appears to be a relatively safe sport. More research is needed, particularly that which examines riders in other NORBA categories as well as off-road riders at the recreational level to determine injury patterns. In addition, information needs to be collected at race sites by medically trained personnel in order to collect more precise information regarding the types and severity of injuries. Data from the present study must be treated with caution, because a self-report protocol was used.