Background Sports injuries in children and adolescents continues to be a growing public health concern. The purpose of this research is to report the 2014–2015 results of the University of South Florida (USF) Sports Medicine and Athletic Related Trauma (USF-SMART) Institute high school athletes’ sports injury data.

Methods The SMART program hires certified athletic trainers (ATCS) to collect data on high school athletes’ sports injuries in schools in west-central Florida. Utilising the Reporting Information Online (RIO) Surveillance System, data were collected by ATCS from 18 large public and private high schools and SAS Version 9.4 was used for the data analysis. Data analysis included descriptive statistics, calculations of injury rates per 1000 athletic exposures, and determination of relative risks.

Results The leading rate of injury per 1000 athlete-exposures for practices was for football at 2.91, followed by men’s cheerleading at 2.23, and women’s wrestling at 2.16. For competitions, the injury rate per 1000 athlete-exposures was greatest for football at 13.1, followed by men’s lacrosse at 6.80 and men’s wrestling at 6.55. Seven-hundred-twenty-six injuries were reported by the ATCs of which the majority of injuries were to males (77.5%) with injuries largely to the head/face, ankles, and knees. The leading type of injury across sports was ligament sprain (27.7%), followed by concussion (23.2%), and muscle strain (11.6%). For all sports, boys had a significantly greater injury rate compared to girls and this was true across competitions and practices (Relative Risk (RR) = 2.79, Confidence Interval (CI): = 2.32–3.34; RR = 2.98, CI: = 2.28–3.88; RR = 2.88, CI: = 2.22–3.74, respectively).

Conclusions The results of this research confirm the important role of various sports injuries among high school athletes with an emerging role for high school lacrosse. The results of these findings will be used to develop targeted interventions to reduce sports injuries in these athletes.