Scottish skiing is a growth industry-nearly all acute ski injuries in Aviemore are managed initially by local general practitioners. This study set out to examine the nature and incidence of ski injuries in one Scottish ski resort, and to calculate the additional workload generated for the health centre, ambulance service and local hospital. During the study period, the winter ski season of 1993-94, a prospective study was made of the 486 acute ski injuries presenting to Aviemore Health Centre. Despite frequently poor weather conditions, the season's injury rate for Cairngorm was 2.43 per 1000 skier days which compares favourably with statistics from other ski centres world-wide. The anatomical pattern of injuries for both downhill skiing and snowboarding was similar to that of other countries. Knee injuries constituted nearly one third of all cases. 8% of injuries involved the ski lift machinery. 31% of casualties underwent radiographic examination, 17% needed hospital referral and 7% required admission to hospital. The management of acute ski injuries can be performed effectively in the primary care setting. It has significant benefits in rural areas by rationalising the use of ambulance and hospital services.