The Emergency Medicine literature has described levels of medical care for mass gatherings in the United States, including for the Los Angeles 1984 Summer and Calgary 1988 Winter Olympic Games. However, there are limited data to describe the type and number of illness or injury that may occur during mass gatherings in an alpine winter environment. To describe the epidemiology of illness and injury seen among spectators at the alpine and snowboarding venues during the Salt Lake City 2002 Winter Olympic Games, we conducted a retrospective review of the Salt Lake City 2002 Olympic Medical Care database for all patient encounters during the operational period of the Games at the alpine and snowboarding venues. The three venues included were: Deer Valley Resort (DVR), Park City Mountain Resort (PCM), and Snowbasin Resort (SBA). Each venue had a medical clinic located on site for spectators and another for athletes. Physicians, nurses, emergency medical technicians, and therapists staffed the clinics. The database was created by Inter-mountain Health Care (IHC) in conjunction with Salt Lake City 2002 Winter Olympic staff and consisted of descriptive reports of all patient encounters from all venues including demographic, epidemiology, and outcome information. IHC maintains the database, and was the sole medical provider for the Games. Each venue had at least 6 days of competition events. Over the 19 days of the Olympiad, a total of 410,160 spectators and 3,961 competitive athletes attended the three venues. There were 841 spectators evaluated and treated at the venue clinics, and mobile medical staff treated 262 spectators. The top five spectator clinic diagnostic categories were: sprain/strain (n=108), miscellaneous trauma (n=103), respiratory (n=88), miscellaneous medical (n=69), and digestive (n=52). Fifty spectators required transport to a hospital for additional care: 27 required transfer by ground ambulance and the remainder were transported by private vehicle. The overall spectator medical utilization rate was 26.9. In conclusion, the rate and acuity of patients seen at the alpine venues during the 2002 Winter Olympic Games was low. Nevertheless, we recommend full on-site physician and nurse staffing with advanced trauma and cardiac life support available during similar events.