Injuries are the leading cause of morbidity and mortality among Canadian adolescents. Rural adolescents may be disproportionally affected by these traumatic events. Differences in risk for injury between rural and urban adolescents remain understudied. We compared adolescent reports of medically attended injury by urban-rural geographic status using a representative national sample of Canadian adolescents. The study involved an analysis of a national sample of Canadian adolescents aged 11 to 15 years (N=7,235) from the 2001-2002 WHO/Health Behaviour in School-aged Children survey. Respondents were classified into five geographic categories according to school addresses. Several differences in risk for injury were documented by urban-rural geographic status. Adolescents from rural regions were more likely to report medically treated injury compared with the reference population from large metropolitan areas. These patterns of medically attended injury suggest that prevention and intervention programs could be better targeted to the needs of specific geographic populations of Canadian youth.