OBJECTIVE: This study describes the magnitude and burden of injuries and illnesses in elite Dutch female adolescent and young adult handball players. DESIGN: A retrospective open cohort study. METHODS: 10 consecutive seasons were studied using a database including all injuries and illnesses needing medical attention. In total, 102 handball players, who participated in a full-time programme of the Dutch Handball Academy between August 2009 and July 2019, were included. Injuries were classified according to the consensus statement of the International Olympic Committee. Exposure hours were categorised into training and competition exposure. Training exposure included all handball and strength and conditioning sessions. Burden was defined as the injury duration in days divided by the total exposure hours. RESULTS: In total, 916 injuries in 101 players and 95 illnesses in 59 players were reported. The average seasonal prevalence was 83.2% for acute injuries and 78.7% for repetitive injuries. The overall incidence rate was 4.24/1000 exposure hours with an incidence of 23.06/1000 competition hours and 2.19/1000 practice hours. The highest average seasonal prevalence and burden were observed for repetitive injuries of the lumbosacral spine, knee and lower leg and acute injuries of the ankle and knee. CONCLUSION: High injury prevalence proportions and competition incidence rates were observed. Repetitive injuries of the lumbosacral spine, knee and lower leg, as well as acute injuries of the knee and ankle, formed the largest problem. Future prevention programmes in elite Dutch adolescent and young adult female handball players should therefore focus on these injuries.