Background Artistic gymnastics is reported to have some of the highest injury rates in sports, which limits participation and often involves considerable medical expenses.

Purpose To critically appraise the epidemiological literature on injury patterns and risk factors in competitive artistic gymnastics.

Study design Systematic review.

Methods Six databases were searched for articles that investigated injuries in competitive artistic gymnasts. Injury incidence, prevalence and risk factor data were extracted, alongside information on injury location, type, severity, nature and mechanism of injury. Quality and level of evidence were assessed using a modified Downs and Black quality index checklist and the Oxford Centre for Evidence-based Medicine guidelines.

Results The search identified 894 articles, with 22 eligible for inclusion. Descriptive analysis showed that injury incidence and prevalence varied from 0.3 to 3.6 injuries per gymnast (female=0.3–3.6, male=0.7) and 2.0–2.3 (female=2.0–2.3, male=2.0), respectively. Male gymnasts sustained mostly upper limb injuries, while female gymnast reported lower limb injuries. Floor was associated with the greatest number of injuries for both male and female gymnasts. Higher competitive level and exposure to competition were risk factors for gymnastics injury: age, body mass, body size, training duration and life stress were significant associated factors.

Conclusion Injury incidence and prevalence results are substantial among artistic gymnasts of all competitive levels. Gymnasts who train at highly competitive levels and are exposed to competition environments are a greater risk of injury. Future researchers should implement consistent reporting methods.