In 1993 there was an estimated 12.6 million in-line skaters in the US. In-line skating is popular because of its affordability and its exercise and recreational value. The main risk factors for injury include speed, obstacles and hard surfaces. Using the National Electronic Injury Surveillance System in US hospitals, 31,000 skaters were reported injured over a 12 month period. Fractures, dislocations, sprains, strains and avulsion made up 67% of all injuries. It is recommended that skaters wear protection equipment including, helmet, wrist guards, knee-pads and elbow-pads. Although head injuries from skating appear low in numbers, helmet protection is also recommended. Further studies are required that assess risk factors for injury and environmental and behavioural aspects.