BACKGROUND: Compared to other sports, combat sports are typically thought to be dangerous and more prone to injury. The injury rates sustained by Muay Thai combat athletes during practice, competition, and tournaments are presented as an overall rate in the literature. However, none of the earlier studies have focused on injuries during official championship matches. Head trauma (5-66%), epistaxis, laceration, contusion (2-28%), soft tissue of the extremities (9-77%), and other conditions have been linked to high rates of disability. In addition to its distinct qualities and growing appeal, Muay Thai is an Olympic Committee and a UNESCO-recognized sport. Our primary goal was to assess the patterns, frequency, and severity of in-ring injuries and collect data for the sports authorities and the literature. The second goal was to determine the relationship between the "referee stop contest/RSC decision" and injury incidence. METHODS: The ringside doctor examined all healthy athletes twice before and after the match. The number of athletes assessed from a combat perspective, the overall number of contests, and the percentage of athletes who maintained their health during the competition were ascertained. Furthermore, following the announcement of the RSC decisions, medical diagnosis, first aid, and hospital referral status were disclosed along with the decision rates. RESULTS: This study included 663 athletes (445 males, and 218 women). A total of 606 athletes (91.4%) had no health issues following official bouts. It was observed that 24.58% of the contests were completed with the RSC decision. 68 athletes (10.25%) received medical treatment; 57 (8.60%) had their matches stopped by the RSC decision. The remaining 11 (1.65%) completed the competition without an RSC decision but requested a medical examination after the bout. According to our study, injuries related to the head and extremities were surprisingly low, at a rate of approximately 4%. Most of the patients required outpatient treatment. Epistaxis, concussion, rib trauma and extremity soft tissue strains were among the most frequent injury categories with percentages of 1.96%, 1.50%, 1.05%, and 1.05%, respectively. For the 17 individuals, the hospital emergency room attendance rate was 2.56%. An urgent operation was scheduled for one patient (0.15%) at the hospital. CONCLUSIONS: Compared to published research, injury rates are comparatively low in Muay Thai in-ring official contests managed by doctors and referees. The data we obtained suggest that RSC decision may be useful in preventing athlete injury.