Objective: The purpose of this study was to determine the cost-effectiveness of requiring all recreational hockey players to wear facial protection. Methods: The authors randomly surveyed recreational hockey players at two indoor hockey rinks in Evendale, Ohio. Data were collected on face protection, injuries, demographic variables and attitudes about protective gear from 11/2005 to 03/2006. Results: We surveyed 190 players. The mean age was 34 +/- 8.7 years and 99% were male. The average hockey experience was 17 years. Forty-six percent of respondents reported at least one serious hockey injury in the last five years. Twenty-four percent of the surveyed population chose to not wear face protection (46/190). The average cost of face protection was $48. The cost to purchase two shields for the 46 players would be $4416. Individuals with face protection reported significantly more sprains and strains that resulted in significantly more physician office visits and specialty physician visits. The extra physician visits would add approximately $4590 for the 46 people needing face protection. Those with face protection reported significantly fewer facial lacerations and facial bone fractures. Requiring face protection should prevent seven facial lacerations and three facial bone fractures over five years. The savings Would be approximately $15,000. The net savings by requiring face protection would be $6,00015 years. In our population, with 24% choosing to not wear face protection, requiring face protection would save $250/5 years/person needing protection. Conclusion: It is cost-effective to require facial protection in all recreational hockey players.