Alpine climbing is a sport whose participants are at risk for a variety of injuries and illnesses. Climbers are venturing into the mountains and attempting routes with ever-increasing difficulty, and it is important to understand the injury and illness concerns of alpine climbers better. Alpine climbers are prone to injuries common to traditional mountaineers and more specialized sport rock climbers. Falls while climbing represent one of the more common causes of serious injury, although acute and chronic musculoskeletal injuries of the hands and extremities are also frequent afflictions. Alpine climbers are at risk for injuries and illness because of the mountain environment where they participate in their sport. Proper preparation for the cold is imperative to prevent frostbite and hypothermia. Worsening symptoms of headache or respiratory symptoms should always alert the alpine climber to possible altitude illness. Understanding the injuries common to the sport can allow providers to deliver the best medical care.