Objectives In this study, we wished to examine the nature and incidence of major spinal injuries sustained by ice hockey players and to add reported cases to a permanent registry. Design The study was a retrospective review of questionnaires returned by physicians reporting spinal injuries due to ice hockey. Setting Canada primarily, with reported cases from other nations. Patients Two hundred forty-one cases of fracture or dislocation of the spine have been reported. Main Outcome Measures The registry includes annual incidence and mortality incidence as well as documentation of sex, age, mechanism of injury, vertebral level of injury, neurologic deficit, type of event, and type of fracture for most cases. Results Between 1982 and 1993, an average of 16.8 ice hockey related major spinal injuries were reported each year. Many of these injuries occurred to the cervical spine of players aged 16–20 years who were playing in supervised games. Conclusions Prevention programs are beginning to become effective in decreasing the number of severe injuries and the number of injuries caused by a check from behind, although there has not been a significant decrease in the total number of injuries reported annually.