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To describe the epidemiology, injuries sustained and outcomes of patients presenting to an emergency department after a bicycle accident in Cambridge, England.A prospective study was conducted of all individuals treated as a result of a cycling accident between 1 April 2003 and 31 July 2003. Information was collected from injured cyclists or relatives by a standardized questionnaire. This included patient demographics, details relating to the accident, and injuries sustained.A total of 293 injured cyclists presented during the study period. The most commonly injured were men (65.5%) in isolated bicycle accidents on roads without cycle paths during daylight hours. Only 20.8% of patients wore helmets. The majority of those injured at night (62.5%) had consumed alcohol (P<0.05). Upper limb injuries were most frequently sustained (64%), with an even distribution of lower limb (24%), head (23%) and facial (22%) injuries. Truncal and neck injuries were uncommon.Although it is recognized that the use of bicycle helmets contributes to a decrease in mortality from head injuries, this should not be the only focus for decreasing the morbidity associated with cycling accidents. Campaigns for safer cycling practice, more dedicated cycle routes and to discourage cyclists from drinking and cycling are essential to decrease the numbers of these injuries.