Background Artificial turf is used extensively in both recreational and elite football in areas with difficult climatic conditions.

Objective To compare the risk for acute injuries between natural grass (NG) and third-generation artificial turf (3GAT) in male professional football.

Study design Prospective cohort study.

Methods All injuries sustained by players with a first-team contract were recorded by the medical staff of each club, from the 2004 throughout the 2007 season. An injury was registered if the player was unable to take fully part in football activity or match play.

Results A total of 668 match injuries, 526 on grass and 142 on artificial turf, were recorded. The overall acute match injury incidence was 17.1 (95% CI 15.8 to 18.4) per 1000 match hours; 17.0 (95% CI 15.6 to 18.5) on grass and 17.6 (95% CI 14.7 to 20.5) on artificial turf. Correspondingly, the incidence for training injuries was 1.8 (95% CI 1.6 to 2.0); 1.8 (95% CI 1.5 to 2.0) on grass and 1.9 (95% CI 1.5 to 2.2) on artificial turf respectively. No significant difference was observed in injury location, type or severity between turf types.

Conclusion No significant differences were detected in injury rate or pattern between 3GAT and NG in Norwegian male professional football.