OBJECTIVE: To review 4 years of National Collegiate Athletic Association (NCAA) injury surveillance data for women's ice hockey and to identify potential areas for injury prevention initiatives. BACKGROUND: The NCAA ISS prospectively collects data on injuries sustained during collegiate participation. Women's NCAA ice hockey began participation in the ISS during the 2000-2001 season. On average, over the 4 years, 15.6% of the eligible schools elected to send their injury data. MAIN RESULTS: Over the 4 years of study, the rate of injury in games was more than 5 times higher than the injury rate in practices (12.6 versus 2.5 injuries per 1000 athlete-exposures, rate ratio = 5.0, 95% confidence interval = 4.2, 6.1, P < .01). Preseason practice injury rates were almost twice as high as in-season practice rates (4.2 versus 2.3 injuries per 1000 athlete-exposures, rate ratio = 1.8, 95% confidence interval = 1.7, 2.0, P < .01). Concussions were the most common injury in both games (21.6%) and practices (13.2%). The rate of concussions in games appeared to be trending upward over the study period. The greatest number of game injuries (approximately 50%) resulted from player contact, whereas practice injuries were from either contact with another object or noncontact mechanisms. RECOMMENDATIONS: Women's ice hockey is an evolving NCAA sport. Only 4 years of ISS data are available and, therefore, data should be interpreted with caution. Women's ice hockey does not allow for formal body checking; however, approximately 50% of all game injuries were reported to result from contact with another player. Future researchers need to evaluate the effectiveness of the no-checking rule. Additional years of data collection will be required to allow the data to become more stable, and to increase attention to mechanism-of-injury issues. We anticipate that the hypothesized inconsistencies in skill level across and within the various women's teams also will be reduced as more consistently skilled players develop, allowing for more stability in the injury scenario.