,Background: The objective was to describe the patterns and mechanisms of water tubing related injuries treated in U.S. emergency departments. Methods: The National Electronic Injury Surveillance System was used to examine cases of water tubing related injuries. Sample weights were used to calculate national estimates of water tubing related injuries. Analyses were conducted in 2010. Results: From 1991-2009 an estimated 69,471 injuries were treated in US emergency departments for water tubing related injuries. The annual number of cases increased 250% over the 19-year study period (P<.001). Sprains and strains accounted for the largest portion of injuries (27.2%). The head was the most frequently injured body part (27.5%). Children and adolescents= 20 years, were more likely than individuals 19 years to sustain sprains and strains (OR: 2.11; 95% CI = 1.64-2.71) and were most commonly injured by impact with the water (54.6%). Conclusions: Patterns of water tubing related injuries differ for children and adults. Research is needed to determine how best to reduce these injuries.