During 2001-2005, an estimated 207,830 patients with SR-related TBIs were treated in U.S. hospital EDs each year, accounting for 5.1% of all SR-related ED visits. Overall, males accounted for approximately 70.5% of SR-related TBI ED visits. The highest rates of SR-related TBI ED visits for both males and females occurred among those aged 10-14 years, followed by those aged 15-19 years. Activities associated with the greatest number of TBI-related ED visits included bicycling, football, playground activities, basketball, and riding all-terrain vehicles (ATVs). Activities for which TBI accounted for greater than 7.5% of ED visits for that activity included horseback riding (11.7%), ice skating (10.4%), riding ATVs (8.4%), tobogganing/sledding (8.3%), and bicycling (7.7%). Each year, an estimated 21,311 SR-related TBI ED visits occurred that involved patients who were either subsequently hospitalized or transferred to another facility for additional care. Approximately 10.3% of patients with SR-related TBIs were hospitalized or transferred, compared with 3.1% of patients with SR-related injuries overall. Activities associated with the greatest proportion of TBI-related ED visits requiring either hospitalization or transfer included riding ATVs (30.2%), riding mopeds/minibikes/dirt bikes (21.9%), bicycling (15.6%), golfing (13.6%), and riding scooters (10.5%).