A retrospective study was performed on 144 anterior cruciate ligament injuries sustained while playing team handball. The incidence of this severe injury was 1.8% per year or 0.82 injuries per 1,000 playing hours in female athletes playing at a high division level, mainly on synthetic surfaces. The risk in other groups, and when playing on parquet, was considerably lower. The injury mechanisms indicate that a major risk factor was too good friction between shoes and playing surface. 2/3 of the injuries were non-contact injuries, and only 1/10 were caused by foul play. Cutting and jumping were the most common causes of injury. Further research on friction between shoe and playing surface is recommended.