During the 25-year period 1970-1994, 680 patients were diagnosed with neck sprain due to causes other than car accidents at the Emergency Room of the University Hospital Groningen. The purpose of the present study was to analyse the prevalence, groups at risk and trends in patients with neck sprain. We defined the population as patients diagnosed with neck sprain that was not due to a car accident (NCA). The binominal test was used to obtain measures of statistical significance, deltax was used to obtain both the total increase in the number of neck sprain victims over the whole period (1970-1994) and the relative contribution of successive 5-year periods. Over the 25-year period a steady increase in the number of patients was observed from 55 in 1970-1974 to 241 in 1990-1994. The highest prevalence was found among 15- to 19-year-olds (3.92 per 10,000), followed by 10- to 14-year-olds (3.40 per 10,000). The major causes of neck sprain NCA were accidental falls (25%), sports injuries (24%) and bicycling injuries. Across the life span, the male: female ratio was 0.63. Ten percent of patients were treated as inpatients. The increase in neck sprain NCA can be only partly attributed to increased media attention. The reduction of working hours resulting in more leisure time activities, which in turn increases the exposure time in at risk situations, and the awareness of both patients and physicians is discussed.