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To determine the injury incidence rate and injury pattern among youth karate athletes competing in national tournaments in Slovakia, and to identify risk factors for injury.Data were collected at nine national youth karate tournaments in Slovakia in 2015 and 2016. Injury incidence rates were calculated per 1000 athlete-exposures (IIRAE) and per 1000 min of exposure (IIRME) with 95% CIs. Subgroups were compared by calculating their rate ratios (RR) with 95% CIs.The overall IIRAE and IIRME were 45.3 (95% CI 38.7 to 52.6) and 35.9 (95% CI 30.7 to 41.7), respectively. The most frequently injured anatomical region was the head/neck (57%), while the most common type of injury was contusion (85%). The risk of injury for the 12–17-year-old age group was almost twice that of the 6–12-year-old age group, after accounting for exposure time (RRME 1.92 (95% CI 1.39 to 2.65)), and the difference was more pronounced for girls than boys (RRME 2.47 (95% CI 1.52 to 4.00) vs RRME 1.62 (95% CI 1.06 to 2.49), respectively).Youth karate has a relatively large proportion of head injuries. Adolescent and female youth karate athletes are at higher risk of injury compared with their child and male counterparts.