This study describes the epidemiology of escalator-related injuries among adults age 65 and older in the U.S. between 1991 and 2005, through a retrospective analysis of data from the National Electronic Injury Surveillance System of the U.S. Consumer Product Safety Commission. There were an estimated 39,850 escalator-related injuries and no fatalities. The overall injury rate was 7.8/100,000 population. During the study period 1991-2005, the rate of escalator-related injuries doubled. The mean age of the study population was 80.1 years (S.D.=8.5 years) with 73.3% female. The most frequent cause of injury was a slip, trip or fall (84.9%, 95% CI: 82.7-87.2%). The most frequently injured body parts were the lower extremities (25.9%, 95% CI: 21.5-30.2%) and the head (25.0%, 95% CI: 20.5-29.5%). The leading type of injury was soft tissue injuries (54.2%, 95% CI: 49.7-58.7%) followed by lacerations (22.3%, 95% CI: 18.4-26.1%) and fractures (15.6%, 95% CI: 13.1-18.1%). The rate of head injuries and the rate of hospitalizations increased with age. Escalator-related injuries occur infrequently but may result in significant trauma. These injuries are often associated with a slip, trip or fall. Awareness of the risks and the circumstances leading to escalator injuries allows for better direction of intervention strategies on the part of injury prevention specialists.