Paintball is a popular combat game, with more than 5 million participants per year. As it has increased in popularity, the incidence of paintball-related injuries also has increased. The most common injuries are classic, benign skin lesions that are easily recognized if one is aware of them. Devastating eye injuries also may occur if participants do not wear face masks. Other reported injuries include musculoskeletal injuries, solid organ injuries, and vascular pseudoaneurysms. Rarely, paintball-related deaths have been reported. This article is the first to review the full spectrum of paintball injuries; in addition, the article emphasizes the importance of encouraging participants to adhere to appropriate safety measures, particularly wearing an appropriate face mask at all times during the game.