Tyrol (Austria) is one of the regions which pioneered skiing. Skiing is considered as a national sport and is deeply rooted within the school system. Thus most pupils partake in skiing courses in this period. It is clear that such a large group of pupils also leads to a significant number of skiing injuries. Preventive issues may be derived from an analysis of the pattern and circumstances of skiing injuries. During a period of ten years (2000-2009) 1522 school sports injuries have been reported to the health insurance agency (Allgemeine Unfallversicherungsanstalt) from all secondary schools in Tyrol. The major disciplines were ski (48%, n=734) ice skateing (23%, n=349) and snowboard injuries (21%, n=315), followed by tobogganing (6%, n=91), cross-country skiing (1%, n=17) and other wintersports (1%, n=16). Fractures (31%) dominated in skiing, followed by contusions (23%), and sprains (22%). In the analysis of the distribution of injuries during alpine skiing accidents, lower extremity injuries (39%) dominated followed by upper extremity injuries (34%). Head and spine injuries (13%) were rare. Analysing the circumstances of the injuries, most injuries during skiing occurred without person to person collision (82%), 81% either shortly before lunch-break or in the afternoon. Skiing injuries account for a significant proportion of all school sport-related injuries in Tyrol. Lower extremity injuries account for the vast majority of all injuries. Overestimation and overtiredness may be responsible for skiing sport injuries. Preventive measures such as a fitness training (e.g., skiing exercises) prior to skiing courses, appropriate breaks and proper protective gear (i.e., helmet and spine protector) may reduce the injury rate in skiing school sport.