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Youth ice hockey tournament injuries: rates and patterns compared to season play. Med. Sci. Sports Exerc., Vol. 31, No. 1, pp. 46-51, 1999.To prospectively document the incidence of game injury rates in youth ice hockey tournaments to compare with season-long game injury rates and to analyze the injuries occurring at tournaments by mechanism, type, body location, severity, player position, and period of play.A prospective injury report form completed for injured players by the tournament athletic trainer.Four boys' tournaments and one girls' tournament during the 1993-94 season.807 boys and girls, ages 9-19.60 injuries occurred in boys and 4 occurred in girls. There were 26 boys with significant injuries and no girls with significant injuries. The significant game injury rates per 1000 player hours were 50.9 for boys combined, 57.9 for boys' Peewee A, 42.7 for boys' Bantam A, 64.8 for boys' varsity high school, 44.8 for boys' Junior Gold, and 0 for girls' Peewee A and B. Cerebral concussion comprised 15% of boys' injuries.The significant injury rate for boys' tournament game play was 4-6 times higher than the season game injury rates in two previous season-long studies. In boys' games, 65% of "all" injuries and 77% of "significant" injuries were related to collisions. The girls' rules of play do not allow body checking, and there were no significant injuries in girls' games. The boys had high rates of cerebral concussion injury at all age levels. Minimizing the frequency and intensity of collisions in the boys' game may decrease the injury rates, especially in the tournament setting.