This study established the cumulative incidence per season of ball carrier spearing and concurrent defensive spearing by tacklers for a New Jersey high school football season. Spearing (flexing the neck and initiating contact with the top of the helmet) is a significant cause of injury to the head and neck in football. To reduce the risk of head and neck injuries in football all types of spearing must be explored. Nine game films from the 1989 football season were viewed to determine the incidence of ball carrier spearing and concurrent defensive spearing. There were 167 incidents of ball carrier spearing (1 per 5.1 plays) and 72 incidents of concurrent defensive spearing (1 per 2.3 ball carrier spears). Officials can now penalize any player who initiates contact with his head. However, there were no spearing penalties called throughout the 1989 season. This study detected a surprisingly high cumulative incidence of ball carrier spearing and concurrent defensive spearing, along with poor enforcement of the spearing rule. To further reduce the risk of head and neck injuries officials should acknowledge ball carrier spearing as a rule infraction and enforce existing spearing rules during the tackling process. Coaches also should teach and drill correct technique with ball carriers, tacklers, and blockers throughout the season.