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Sports participation for the physically disabled is rapidly growing in popularity and competitiveness, but little is known about the sports medicine needs of these unique athletes. We wished to determine the medical needs and injury profiles of a group of elite disabled athletes competing at an international level. The Canadian team that competed at the 1988 Seoul Paralympic Games consisted of 151 athletes: 58 in wheelchair, 39 blind, 30 with cerebral palsy, and 24 amputees. Analysis of the records of treatment provided by the Canadian medical contingent showed that 82% of the athletes received medical attention. Fifty-one percent of the conditions observed were musculoskeletal (MSS) and 49% were acute (developed at the Paralympics), whereas 51% were chronic (developed before the Paralympics). The shoulder was the most common site of MSS injury, and rotator cuff impingement syndrome was the most common clinical diagnosis. Upper extremity injuries were most prevalent in athletes participating in “arm-dominant” sports, whereas lower extremity injuries were significantly more common in leg-dominant sports. A disproportionately high number of leg injuries were incurred by blind athletes, whereas most of the back injuries occurred in cerebral palsy athletes. Forty-nine percent of medical treatment was for general medical problems, the most common of which were upper respiratory tract infection and gastroenteritis. Medical conditions specific to the particular athlete's disability were also noted. We conclude that sports medicine services are important for this group of athletes and that care providers should be prepared to deal with MSS injury, general medical illnesses, and disorders specific to each disability. The injury profiles suggest that both type of sport and type of disability are factors in injury location.