We conducted an 8-year, prospective, longitudinal study of athletic injuries occurring to students in grades 7 to 12 at a private school in Honolulu. All injuries were evaluated by the same personnel. A total of 14,318 athletes participated in 32 sports; multisport athletes were counted once per sport. Every time an athlete sought medical help it was considered a reportable injury. The five injury classifications were 1) minor, no time lost; 2) mild, 1 to 7 days lost; 3) moderate, 8 to 21 days lost; 4) severe, 22 or more days lost; and 5) catastrophic, permanent disability or death. Athletes reported 11,184 injuries, with 3965 (35%) day-lost injuries (a minimum of 1 day lost from activity). Football resulted in the highest injury rate for male athletes. Soccer resulted in the highest injury rate for female athletes. With the football and wrestling data removed, there was no significant difference between the rate of injury for boys (0.58 injuries per athlete and 0.21 day-lost injuries per athlete) and girls (0.64 injuries per athlete and 0.21 day-lost injuries per athlete).