Background The pole vault is a track and field event that has witnessed a large increase in participants during the past 5 years. Currently there are no prospective studies that have evaluated injury patterns in pole vaulters. Objectives To determine the injury rate and to describe injury patterns in high school pole vaulters. Study Design Descriptive epidemiological study. Methods This was a prospective cohort study of 140 Wisconsin high school athletes who participated in pole vaulting during the 2005 and 2006 track and field seasons. Baseline athlete information was obtained at the beginning of each season. When an injury occurred, an injury report form was completed to document diagnosis and circumstances of the incident. Injury rates were expressed as injuries per 100 athletes per season as well as injuries per 1000 athletic exposures. Risk factors were analyzed by calculating relative risks for baseline athlete variables. Results The injury rates were 26.4 injuries per 100 athletes per season (95% confidence interval, 18.6–36.4) and 7.1 injuries per 1000 athletic exposures (95% confidence interval, 5.0–9.8). Trauma to the lower extremities accounted for 71.5% of injuries. The most common injury types were ligament sprains (31.6%). Landing incorrectly was the most frequent mechanism of injury (26.3%). A history of pole-vault injury was associated With increased risk of injury (relative risk, 2.4; 95% confidence interval, 1.4–4.1). Conclusion Injuries are common in young vaulters. Injury mechanisms indicate that many could be avoided by using proper technique, particularly during the landing phase. Coaches should focus on vaulters with prior injuries to identify risky behavior and to help correct poor technique.