Every fifth unintentional injury treated at a healthcare facility in the industrialised part of the world is associated with sports or physical exercise. This article reviews the literature regarding the theoretical and practical underpinnings for community-based sports safety promotion, including both professional and recreational sports. While injury prevention entails the implementation of specific interventions in terms of structural or educational measures, sports safety promotion includes also the antecedent and wider campaigns that are required to succeed with these measures. Comprehensive sports safety promotion programmes thus require that the perspective on the sports injury problem is made broader than consideration of the individual athlete. The results display that involvement in sports safety issues from the sports federations that formulate policies and allocate resources is necessary for coordinated implementation of programme actions. The authorities responsible for sports facilities and legislations in the civil society also need to be included, because of the fact that they control many of the central safety determinants in the sporting environment. It is concluded that the sports injury problem needs to be addressed in liaison with the leaders of socially defined sports communities and the governments representing geographically defined civic communities, and that the safety-supporting environment in professional sports is underdeveloped compared with other areas of working life.