The purpose of this study was to examine the injury incidence and pattern of injuries in youth female and male team handball players using two different prospective registration methods; match reports (90 teams, 1080 players) and coach reports (34 teams, 428 players). A total of 118 injuries were recorded by the coach report, of which 93 (79%) were acute injuries (incidence training: 0.9+/-0.16 injuries/1000 player hours; matches: 9.9+/-1.26; rate ratio vs training: 10.8 [95% confidence interval (CI) 7.0-16.6]; P<0.0001) and 25 (21%) were overuse injuries. Knee (26%) and ankle (24%) injuries accounted for half of the acute injuries (training: 0.5+/-0.12 injuries/1000/h; matches: 4.4+/-0.84; rate ratio vs training: 8.0 (95% CI 4.5-14.5); P<0.0001). No gender difference was found in the injury rate (rate ratio female vs male: 1.3 (95% CI 0.8-2.1); P=0.40). Most of the injuries occurred in the attacking phase by back or wing players doing a plant-and-cut, landing or turning movement, and more than half in contact situations with the opponent. Similar results were observed for acute match injuries in the match report. These results indicate that the rate of injuries in youth team handball is as high as at the senior level, and prevention should focus on knee and ankle injuries. The coach report seems to be the best method to register injuries in youth team handball to provide a full spectrum of injuries according to their type, incidence and severity.