Ice hockey is a sport enjoyed by many men and women at the spectator and participant level. It is played with high intensity and often involves body contact. Although the women's games is far from injury free, it is the men's game that has drawn criticism for excessive violence. Much attention has been drawn to the serious injuries that have occurred in ice hockey, specifically spinal injuries, concussions, and eye injuries. Many such injuries are the result of illegal and violent acts such as checking from behind or a deliberate high stick. Because of this, some medical organizations have called for changes in the sport, such as minimum age requirements for body-checking. As a practical matter such changes are unlikely to be accepted by hockey governing boards. Many of those involved in the sport consider body-checking a fundamental component of the game. Furthermore, a distinction needs to be made between any kind of injury and a serious, catastrophic injury. For example, although a recent study found that body-checking accounted for up to 38% of ice hockey injuries, none were of the catastrophic type. With respect to catastrophic injuries such as spinal cord trauma or a blinded eye, legal body-checking accounts for significantly less than illegal body-checking (e.g., checking from behind) or violent stick work. To reduce serious injury in ice hockey, we offer 10 recommendations, key among them automatic game suspensions for certain rules violations, and recognition of the coach as the most important figure in promoting a clean, safe game.