Musculoskeletal injury in children can lead to negative physical， psychological and socio-economic effects. This study aimed to examine sport and recreation injury incidence in Irish primary school children. A crosssectional survey of 842 male and female Irish primary school children (9.62 ± 1.7 years) was conducted. Parents completed a questionnaire examining estimated weekly participation in sport and recreation and any injuries sustained in the previous 12 months that resulted in restricted performance， restricted ability to fully take part in or time lost from sport， recreational activities or school. Overall， 28.3% sustained an injury in one year， of which 30% presented to their local hospital emergency department. Sports injuries (0.15 per 1000 hours) were significantly more common than recreational injuries (0.04 per 1000 hours). Contact injuries were predominant (78.4%)， with falling (19.3%)， running (16.9%) and tackling/being tackled (16.5%) most common. Finger/thumb and ankle injuries were most common. Knee injuries resulted in the greatest injury burden (4.77 days absent per 1000 hours of sport and recreation) and 3 in 10 injuries were referred for a scan. A multi-level approach to managing and reducing sport and recreation musculoskeletal injuries in primary school children that targets all relevant stakeholders including parents， teachers， coaches and the children themselves should be considered to promote safe play and sporting participation for children.
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