Background Emergency responders frequently incur injuries while providing medical, fire, and law enforcement services. National surveillance systems provide fragmented perspectives on responder injuries because they omit specific classes of workers (e.g., government or volunteers); they report only selected injuries; and employment information is incomplete. Methods We characterized injuries among emergency medical services (EMS), fire-fighting, and police occupations by using data from the National Electronic Injury Surveillance System-Occupational Supplement (NEISS-Work)for injuries treated in U.S. hospital emergency departments in 2000-2001. Results Sprains and strains were the leading injury (33-41%) among EMS, firefighter, and police occupations. Police officers and career firefighters had the highest injury rates (8.5 and 7.4 injuries per 100 full-time equivalent workers, respectively). Conclusions The physical demands of emergency response area leading cause of injuries that may benefit from similar interventions across the occupations. To assess risk, improved exposure data need to be acquired, particularly for volunteers. Am. J. Ind. Med. 53:1-11, 2010. Published 2009 Wiley-Liss, Inc.(dagger)