BACKGROUND: Sports participation is the 4th leading cause of non-combat injuries among non-deployed U. S. Army Soldiers comprising 11 % of injury hospitalizations and 35% -75% of injuries treated in ambulatory clinics. Basketball (23%), football (22%), softball (8%), and physical fitness training (6%) are the leading sports activities resulting in injury hospitalizations. Little is presently known about the incidence of sports injuries among Soldiers deployed for military operations such as Operation Iraqi Freedom (OIF). PURPOSE: To determine the incidence of sports-related injuries that required medical air evacuation of U.S. Army Soldiers deployed for OIF and to describe the distribution of sports, injury type, and anatomical site for these injuries. METHODS: Soldiers air evacuated from OIF with non-combat injuries between March 19, 2003 and June 30, 2005 were identified from an administrative database that tracks all air evacuations. In addition to demographic and administrative data for each case, this database included medical information such as patient history and diagnosis. These fields were reviewed for each injury case to identify the injury cause, diagnosis, and anatomical site of injury. Descriptive statistics were used to describe the distribution of sports-related injuries by sport, diagnosis, and anatomical location of injury. RESULTS: 6, 977 soldiers required medical air evacuation from OIF to receive specialty care for a non-combat injury. Of cases with a known injury cause, sports-related activities comprised 16% (rate: 22/10, 000 person-yr). Mean (± SD) age was 30 ± 8 years and gender was predominantly male (94%). Basketball (25%), football (21 %), physical fitness training (20%), and weight lifting (7%) were the primary sports involved. The leading injury types were fracture (27%), dislocation (23%), sprain/strain (23%), and pain/inflammation (7%). Injuries primarily involved the knee (28%), wrist/hand (17%), ankle/foot (12%), shoulder (12%), and lower leg (8%). CONCLUSION: Injuries from sports and physical fitness training comprised 16% of non-combat medically air evacuated injuries from OIF. This proportion, as well as the particular sports involved, is similar to that reported for injury hospitalizations among non-deployed Soldiers.