We describe the cases of 20 patients who received injuries while falling from mechanical bulls. Injuries were received in three ways: 1) from striking the ground; 2) from striking the bull or getting caught on the bull; and 3) from the concussion caused by bucking. The severity of injury ranged from minor sprains to thumb fractures and lumbar vertebral fractures. The patients presented with three things in common: 1) they had (with one exception) no previous bull-riding experience; 2) they had consumed alcohol; and 3) they had suffered an orthopedic injury. We have chosen to call this manifestation the Urban Cowboy Syndrome.