Despite their popularity and unique characteristics, county shows, also known as agricultural fairs, are amongst the least-studied mass-gathering events. Suffolk Show is one of the biggest such events in the UK, attracting tens of thousands of people annually over a 2-day period. In addition to trade stands and livestock displays, the 2011 show included top international show jumping and other sport activities. Problem Due to the range of activities and large number of attendees of different ages and medical backgrounds, combined with a lack of objective data about medical contacts made during these events, medical officers and local emergency services find planning an appropriate level of medical coverage for county shows particularly challenging. This study involved analyzing the characteristics of medical contacts during a major county show and assessing the level of medical coverage provided. Data collected from St John Ambulance (SJA) and British Red Cross standard medical records of all contacts on the show ground over the two days were analyzed in terms of demographics, presenting complaints, medical history, and discharge destination. The Event Safety Guide by the Health and Safety Executive (HSE) was the agreed standard for the level of medical coverage. More than 90,000 people visited the show, with a total of 180 medical contacts recorded. Patient presentation rate (per 1,000 attendees) was 2.0 and the transport to hospital rate (per 1,000 attendees) was 0.1. Of the 112 cases handled by SJA, 74 (66%) were women and 49 (44%) were 18-64 years of age. Wounds, lacerations and abrasions made up 26 (23.2%) of all presentations to SJA, followed by foot and lower limb blisters at 20 (17.8%). Hypertension was the most common medical history in presentations to SJA (11 cases, 10%), followed by asthma in 7 (6%). The majority of presentations were due to minor injuries or ailments. An understanding of the event characteristics, demographics, and nature of medical contacts will provide organizers, medical officers, and local emergency services with information about the level of coverage and resources required. This data can further help advance knowledge of mass-gathering medicine across the various types of events.