Background In China, university students might be more physically active as their release from heavy academic burdens for college admission and independence from parents, resulting in their frequent engagement in relatively risky activities without parents’ supervision. Correspondingly, an increment of physical activity-related injury (PARI) can be expected.

Objective This study, funded by the National Natural Science Foundation of China (No. 31640038), was designed to investigate the epidemic and explore risk factors of PARI among Chinese university students via a multi-center survey.

Methods By the method of cluster sampling, students graded 1–3 from eight universities in four Chinese cities (namely Shantou [Guangdong], Jinan [Shandong], Xi’an [Shanxi] and Nanchang [Jiangxi]) were selected and invited to complete the online questionnaire during March and April, 2017. The questionnaire was comprised of basic characteristics, physical activity (PA) involvement, sleep duration, and PARI episodes happened in the past 12 months. The multivariate logistic regression was used to estimate risk factors for PARI.

Findings Of 5341 participants, 1293 suffered from PARI in the past 12 months, with an overall rate of 24.2% (males: 26.2%, females: 23.2%). More than one fifth of the injured (22.9%) sustained PARI at least three episodes. Over half of the injured (57.3%) experienced a withdrawal time of PA and nearly two fifth (39.6%) received medical treatment owing to PARI. Frequent PA participation, including vigorous-intensity and moderate-intensity, with longer duration would elevate risk for injury. Males, sports team members, and those with diagnosed chronic conditions were also at higher risks.

Conclusion and policy implications PARI was prevalent among Chinese university students. Being physically active would increase risk for injury. The above data provide insights that focused and effective injury-intervention approaches should be implemented in university students. Safety issues should also be emphasized when promoting PA to the public to reduce PARI occurrence.