Purpose Wrestling injuries in female athletes is an understudied topic. The aim of this study is to characterize the injuries that occur in female wrestlers aged five to 18 who presented to United States (US) emergency departments (ED) from 2014-2023 and compare patterns between youth and adolescent wrestlers. Method This was a retrospective comparative study including female patients aged five to 18 years of age presenting to the ED due to an injury related to their participation in the sport of wrestling. Data was extracted from the National Electronic Injury Surveillance System (NEISS) from 2014 to 2023. Information extracted included patient demographics, injury location, disposition, diagnosis as well as a narrative for each patient. Injury distribution for youth (five to 11) and adolescents (12-18) was evaluated using chi-squared. Results An estimated 28,824 female wrestlers (841 NEISS cases) presented to US EDs during the study period. The most frequently injured body parts were the head (16.5%), shoulder (14.0%), knee (11.1%), and elbow (10.7%). Strains/sprains were the most common injuries in both youth (27.9%) and adolescents (30.3%). Fractures were significantly more common among youth wrestlers (23.1%) compared to adolescents (13.6%, p < 0.05). The distribution of injured body parts was also significantly different between groups (p < 0.05). In youth wrestlers, the most common injury sites were the head (11.5%, 95% CI 20.0-57.7%), wrist (10.6%, 95% CI 9.85-47.4%), and elbow (9.6%, 95% CI 16.3-56.6%). For adolescents, the head (17.2%, 95% CI 24.9-34.9%), shoulder (14.9%, 95% CI 31.4-43.5%), and knee (11.7%, 95% CI 27.7-41.0%) were most frequently injured. Overall, more than 60% of injuries occurred above the waist in both groups. Conclusion Adolescent female wrestlers experienced more injuries compared to youth wrestlers, with most injuries occurring above the waist. Factors such as increased mat time, hormonal changes, and higher practice intensity may contribute to this disparity. Injury prevention strategies, including adequate mat spacing and rule enforcement during practices as well as upper body strength training, are recommended. Further research is needed to identify mechanisms and specific techniques linked to higher injury risks to enhance safety in female wrestling.