Surfing carries a well documented risk of head and facial injuries and these injuries may have become more frequent in recent times with overcrowding at beaches and the streamlining of surfboard design. Ocular trauma caused by surfboards can be severe, with long-term effects on the work prospects and lifestyles of otherwise fit, young people.There is an increasing number of case reports of severe surfboard related eye injuries (SREIs) and active discussion in the medical literature about the need for protective eyewear while surfing. Studies have found that protective headgear is seldom worn by surfers. No studies have examined the incidence of SREIs among surfers of all levels of experience in New South Wales or Australia. We need data on these injuries to establish the extent of the problem so that recommendation for the use of protective eyewear and headgear while surfing and guidelines for surfboard design can be developed for the Australian context, if required. In this prospective study, we aimed to determine the incidence, nature and severity of SREIs in NSW over 1 year, between 30 December 2010 and 30 December 2011.