Saws are a common source of upper extremity injury. There have been several commercial and government-mandated safety mechanisms designed to reduce the number of saw injuries. We aim to assess the trends in the incidence and impact of saw-related upper extremity injuries over the last 2 decades. The National Electronic Injury Surveillance System database was queried from January 2003 to December 2022 for upper extremity injuries caused by saws. Summary statistics for primary body part injured and diagnosis were calculated. Linear regression was performed to evaluate trends in the number of injuries over time. An estimated 1.38 million injuries (weighted) presenting to emergency departments were reported from January 2003 to December 2022. Patients had a mean age of 50.5 ± 18.1. Digits (82.2%) accounted for most injuries, followed by hands (11.9%). The lower arm (3.4%), wrist (1.66%), shoulder (0.3%), elbow (0.2%), and upper arm (0.2%) accounted for fewer injuries. There was a downtrend in number of saw injuries over the study period (R = 0.83, R2 = 0.69, p < .001). Subgroup analysis showed decreases in number of injuries to fingers (R = -0.82, R2 = 0.67, p < .001) and wrists (R = -0.61, R2 = 0.37, p = .004). The most common diagnoses were lacerations (69.7%), fractures (12.6%), and amputations (9.9%). Upper extremity saw injuries have significantly decreased over the last 20 years. The fingers and hands account for the vast majority of saw injuries, resulting most commonly in lacerations, fractures, and amputations. IV.