Tournament water skiing is an increasingly popular and internationally successful sport in Great Britain, despite the climate. The kinematics and injury patterns of the three disciplines will be unfamiliar to most clinicians and are described, with estimation of the stresses. Advances in equipment over the last 15 years have reduced the risk of severe injury in the tricks event, while high speed impacts are responsible for the majority of trauma in slalom and jump. There is a surprisingly high incidence of injury to the lumbar spine during the high impact jump event. Comparison with findings in other sports suggests that the spine may be damaged by overuse, particularly before skeletal maturity.