Abstract: REASON FOR PERFORMING STUDY: Although anecdotal reports of increased orthopaedic injury risk in equine sports exist, there is little scientific evidence to support this. OBJECTIVES: To test whether horses undertaking a single competitive sport have increased risk of specific injuries compared to those used for general purpose riding (GP); and whether injury type varies with sport category and performance level. METHODS: Data from 1069 records of horses undergoing orthopaedic evaluation (1998-2003) and meeting inclusion criteria were reviewed. Sport category (GP, showjumping, dressage, eventing, racing), level (nonelite or elite) and diagnosis were recorded. Effects of sport category and level on probability of a specific diagnosis were assessed using chi-squared tests. Logistic regression was used to determine which competitive sports and levels increased risk of injury compared with GP. RESULTS: Overall there was a significant effect of sport category and level on diagnosis (P<0.0001). There was significant difference between anatomical site injured and sport category (P<0.0001); a high risk of forelimb superficial digital flexor tendon injury in elite eventing (P<0.0001) and elite showjumping (P = 0.02); distal deep digital flexor tendon (DDFT) injury in elite showjumping (P = 0.002); and hindlimb suspensory ligament injury in elite (P<0.0001) and nonelite (P = 0.001) dressage. There was a low risk of tarsal injury in elite eventing (P = 0.01) and proximal DDFT injury in dressage (P = 0.01). CONCLUSIONS: Horses competing in different sports are predisposed to specific injuries; particular sports may increase the risk of injury at certain anatomical sites; and the type and site of injury may reflect the type and level of performance. POTENTIAL RELEVANCE: These findings could guide clinicians in the diagnosis of sport related injuries.