The injuries sustained in the first European Knock-down Karate Championships in 1978 are described. Thirty-seven of the 70 competitors sustained an injury. Fifteen of these are potentially serious, head injuries, injuries to the trunk, and hematomata compressing the fascial compartments of the limbs. It is concluded that fights were well controlled by the referees but that protective padding should be used and that wood breaking for further advancement in the competition should be of less importance. Finally, it is concluded that the attendance of a medical officer is mandatory.