The role of the team physician for intercollegiate ice hockey teams is unique. Owing to the rather diverse characteristics of many of the mechanisms of injuries for on-ice activities, it is important that team physicians have a good knowledge of the fundamentals of the game in order to understand when a player can return to on-ice activities. It is also essential that the team physician understands the underlying passion in the great majority of players for returning to competition. Unlike many other sportsmen, ice hockey players have a strong desire to return to competition, even after fractures or dislocations that would make athletes in other sports be sidelined for long periods of time. Therefore, in addition to understanding the on-ice activities, it is important that the team physician understands the individual athletes, either personally or through his/her relationship with the team’s athletic trainer, to determine a safe time for these athletes to return to competition. The purpose of this review is to summarise the main injuries seen in high level intercollegiate ice hockey and to review the practical treatment problems for physicians who provide coverage for high level amateur hockey teams.