This paper describes 182 cases of spinal injuries in North American ice hockey players occurring between 1966 and 1991. One hundred and seventy-three injuries occurred in Canada, 8 in the United States, and one Canadian player was injured in a game in Germany. The median age of the players was 18 and 96% were males. One hundred and thirty-eight had neck injuries. The majority of the injuries occurred in games in organized leagues. Spinal cord injury occurred in 106 cases, 51 of whom had complete spinal cord injuries. Collision of the helmeted head with the boards, especially following a check or push from behind, was the most common mechanism of injury. It is felt that most of these injuries are preventable.