Telemark skiing has become increasingly popular over the past 5 years. Telemark skiing poses unique risks when compared to alpine skiing, because of different equipment, technique, and varied skiing environments. A retrospective survey of telemark skiers was conducted in Western Washington in 1994 to obtain skier information on ski habits, demographics, frequency and types of injury, and equipment used at time of injury. During the 5 month survey period, 118 (63%) of 187 surveys distributed at 7 sites were returned. The overall injury rate was comparable to alpine skiing injury rates at 10.7/1000 skier days. Less experienced skiers and women had higher injury rates, 20/1000 and 13.1/1000 skier days, respectively. The predominant injury sites were knee (41%), hip (13%), and thumb (8%). The knee injuries sustained by telemark skiers appear to be less severe than alpine skiers, with less duration of disability and lower surgical rates. An association was found between the use of plastic reinforced boots and significant ligamentous knee injuries when compared to skiers with leather boots (p < 0.01, chi 2 = 5.43).