Background: Snow sports such as skiing and snowboarding are recognized as hazardous, but population-based injury rates or specific risk factors have been difficult to estimate as a result of a lack of complete data for both numerator and denominator.

Methods: We used data from 3 surveys to estimate the number of participants and annual number of outings in Quebec by age, sex, activity, and calendar year. Injuries reported by ski patrollers were used to estimate injury rates among skiers and snowboarders for the head and neck, trunk, upper extremity, and lower extremity.

Results: Head–neck and trunk injury rates increased over time from 1995–1996 to 1999–2000. There was a steady increase in the rate of injury with younger age for all body regions. The rate of head–neck injury was 50% higher in snowboarders than in skiers (adjusted rate ratio [ARR] = 1.5; 95% confidence interval = 1.3–1.8). Women and girls had a lower rate of head–neck injury (0.73; 0.62–0.87). Snowboarders were twice as likely as skiers to have injuries of the trunk (2.1; 1.7–2.6), and more than 3 times as likely to have injuries of the upper extremities (3.4; 2.9–4.1). Snowboarders had a lower rate of injury only of the lower extremities (0.79; 0.66–0.95). Snowboarder collision-related injury rates increased substantially over time.

Conclusions: Except for lower extremity injuries, snowboarders have a higher rate of injuries than skiers. Furthermore, collision-related injury rates have increased over time for snowboarders. Targeted injury prevention strategies in this group seem justified.