In this prospective study, we investigated whether a history of previous low back injury and dissatisfaction with a coach and teammates could predict future low back injury in varsity athletes during a 1-year follow-up period. Of 679 Yale varsity athletes surveyed in 1999, 18.3% (124) reported that they had sustained a low back injury within the past 5 years, and 6.8% (46) sustained a low back injury in the follow-up season. There were no differences in incidence rates between men and women or between athletes involved in contact or noncontact sports. A history of low back injury was the significant predictor for sustaining low back injury in the following year, and athletes who reported previous low back injury were at three times greater risk. Athletes who still had pain at the time of the survey were six times more likely to sustain a low back injury than were athletes without a history of low back injury. These results suggest that some risk factors associated with a history of low back injury predispose athletes to sustain recurrent injury. They may be congenital or a result of insufficient recovery time after the first low back injury episode.