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To compare the incidence and anatomic distribution of injuries sustained in spin and fast bowling in young cricketers.A prospective cohort study. Physical characteristics and retrospective data (sporting involvement and previous injuries) from young cricketers were recorded. The cohort of young cricketers was divided according to style of bowling into a group of spin bowlers and a group of fast bowlers. Data from the spin bowler group was compared with the data from the fast bowler group to assess whether these groups were matched. A prospective study of injuries sustained by the bowlers was then undertaken. Data regarding cricket played and injuries sustained were collected by telephone questionnaire every 6 weeks for 6 months from each bowler.Bowlers were recruited from young cricketers training at Centers of Excellence of 3 “First Class” Counties in England in January 1998.There were 42 spin bowlers and 70 fast bowlers. The mean age was 14.9 years (range 9 to 21 years).Injuries caused by bowling and interfering with bowling are included in incidence data. The number of deliveries bowled in matches and practice is used as the denominator for the reported incidence.Telephone follow-up was achieved when planned on 98.2% of occasions. There were 29 injuries meeting the criteria above. The incidence of injury in spin bowlers was 0.066 per 1,000 balls and 0.165 per 1,000 balls in fast bowlers (p = 0.097 Wilcoxon rank sum test). The incidence of injury (per 1,000 balls) at various anatomic sites in fast bowling was knee 0.057, ankle 0.043, low back 0.029, and shoulder 0.007. In spin bowlers, the site incidence was shoulder 0.055 and low back 0.011. The percentage with injuries at ankle, knee, and shoulder was significantly different (95% confidence intervals) for fast and spin bowlers. A significant difference was not found for lower back injuries.Incidence of injuries in fast bowling is greater than in spin bowling (but this was not a significant difference within the limits of this study). Low back injuries in fast bowlers have been the subject of published research. However, injuries in spin bowling have not previously been described, and this study indicates that shoulder injuries in wrist spinners merit further study.