OBJECTIVE: To examine the cost of inpatient-care for sports-related injuries resulting from a shove, collision or tackle. METHODS: Hospital data for all reported discharges in 2000 from 5 states were examined using ICD-9 diagnosis and E-codes (E886.0) to identify the type and circumstances of injury. These databases were used to examine demographics, inpatient hospital costs, length of stay (LOS), and disposition patterns. Cost estimates include all accommodations and ancillary services and are reported in US$2003. Physician-related costs are not included. Hospital charges were adjusted using a 0.61 cost-to-charge ratio and inflated using the appropriate annual medical inflation indices of the U.S. Consumer Price Index. RESULTS: Of the 1017 cases identified, 83% were male. Prior to admission, 63% were treated in the Emergency Department, 2% had ambulatory surgery and 1% spent time in an Observation Unit. The mean age was 24 years with most (56%) being less than 20 years old; 8% were < 10 years. Only 4% were aged 50 years or older. A wide variety of injuries were coded as the principal diagnosis. Injuries recorded most frequently included lower limb fractures (40%), upper limb fractures (24%) and head injuries (10%). The mean total LOS was 2.3 days (median: 2, range: 1-40). The mean cost per stay was $3,876 (median: $3,373, range: $560 - $476,170). The hospital case fatality rate was <1%. Among survivors, 97% were discharged home (4% with home health care) and 3% required additional sub-acute inpatient care (i.e., rehabilitation, skilled nursing). Managed care organizations were the responsible payer for slightly more than half (54%) of the cases. CONCLUSIONS: Most of the hospitalizations for sports-related injuries occurred among adolescents and young adults. This analysis draws attention to the clinical and economic consequences of participation in sports where physical contact with others is an integral component.