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To examine and compare the types, frequency, and associated risk factors of injuries sustained in snowboarders with downhill skiers. Prospectively administered survey. All snowboarders and skiers who presented to a rural hospital emergency department in California during one winter season were asked to answer a survey eliciting information regarding participants' demographics, previous experience, equipment use and circumstances surrounding their injury. An overall response rate of 87.4% yielded examination of 355 injured snowboarders. Victims tended to be male (81%) with a mean age of 19.8. Snowboarders were more likely to injure the upper limb than skiers (58% vs. 32%, respectively, p < 0.001) but less likely to injure the lower extremities (16% vs. 35%, p < 0.001). Wrist injuries were most common. Nonorthopedic injuries were less common but potentially life threatening. The data also suggest that aerial maneuvers are associated with increased risk of injury to the head, face, spine, and abdomen and that collisions are associated with more severe injury. Snow conditions had no apparent effect on the type, location, or severity of injury and the reported use of alcohol and drugs was low (7%). It was estimated that snowboarders comprised 20 to 25% of participants on the slope but represented 45% of emergency department visits. There exists a wide spectrum of injuries from snowboarding, ranging from common extremity injuries to potentially life-threatening nonorthopedic trauma.