The injury burden in collision sports is relatively high compared to other team sports. Therefore, participants in these sports would benefit by having effective injury prevention programs. Exercise-based interventions have successfully reduced injuries in soccer, but evidence on exercise-based interventions in tackle collision sports is limited. The objective of this review is to systematically examine the evidence of exercise-based intervention programs reducing injuries in tackle collision sports. PubMed, EBSCOHost, and Web of Science were searched for articles published between January 1995 and December 2015. The methodological quality was assessed using an adapted Cochrane Bone Joint and Muscle Trauma Group quality assessment tool. The inclusion criteria were (1) (randomized) control trials and observational studies; (2) sporting codes: American, Australian and Gaelic Football, rugby union, and rugby league; (3) participants of any age or sex; (4) exercise-based, prehabilitative intervention; and (5) primary outcome was injury rate or incidence (injury risk). The exclusion criteria were (1) unavailability of full-text; and (2) article unavailable in English. Nine studies with a total of 3517 participants were included in this review. Seven of these studies showed a significant decrease in injury risk. These studies included three sporting codes and various age groups, making it difficult to make inferences. The two highest methodological quality studies found no effect of an exercise-based intervention on injury risk. There is evidence that exercise-based injury preventions can be beneficial in reducing injury risk in collision sports, but more studies of high methodological quality are required.