The aim was to illustrate the incidence and epidemiology of fractures sustained by adults while participating in football. All fractures during 2007-2008 in the Lothian population while participating in football were prospectively collected. 412 footballers (400 males) sustained 424 fractures. The incidence was 6.1/10 000 fractures/years. The average age was 25 (range 12-76) years. 56 (14%) patients were over 40 years. Two (0.5%) open fractures were sustained, on digits. The top five fractures were: radius (108), phalanges (72), ankle fractures (44), metacarpals (29), metatarsals (28). Upper limb to lower limb ratio was 290:136. 143 fractures were in the hand, with four isolated ulna fractures. 16 were fracture dislocations, nine involving the phalanges, five the ankle mortice. 360 fractures were initially treated as outpatients, 18 required admission from clinic and 64 fractures were admitted from A&E. Two patients were professional footballers. Football is the most common cause of sport fractures. While the epidemiology of football fractures will vary as participation varies, the authors believe these results are useful for medical teams involved with football. As the ageing population is actively encouraged to participate in sport there will be increasing numbers of osteoporotic fractures sustained. The authors demonstrated that football fractures are not limited to the young; 13.6% of patients were over 40 years. Upper limb fractures are more common as footballers are likely to sustain fractures after a fall rather than contact injuries. 60% of fractures were sustained below the elbow with only four isolated ulna fractures, probably secondary to direct trauma. Most fractures were closed injuries; no open long bone fractures were seen. Pitch-side practitioners should be aware that 10% of ankle fractures were dislocated with the potential for neurovascular complications. Most patients can be discharged from Accident and Emergency and managed as outpatients, a fifth required inpatient treatment. Most patients were not employed as footballers reflecting participation from all ages and occupations. Football produces significant number of fractures in the general population. Most are closed, sustained below the elbow, and can be managed in the outpatient setting.