The purpose of this study was to analyze injuries among adult recreational ice hockey players. This was an observational prospective cohort study with data collected on injuries sustained during one season in the adult recreational ice hockey leagues of Oneida County, NY. The injury incidence rate was found to be 12.2/1000 player-exposures. The most common anatomic region injured was the head/neck/face (35%). Collisions were most often reported as the mechanism of injury (44%). Fracture was the most common diagnosis. Of players wearing face protection (full cage or shield, or partial visor/half shield), none suffered facial injuries, while all facial injuries reported were to players not wearing facial protection. The concussion rate was 1.1/1000 player-exposures. A lack of protective equipment was associated with 38% of injuries and 24% of injuries involved penalties. A history of prior injuries was found in 89% of injured players with 28% re-injuring the same body part. This study’s findings suggested various strategies to address player injuries such as mandatory full facial protection and shoulder pads, strict enforcement of game rules, and game rule modifications (no body checking). Further research is needed on the role of preventive rehabilitation in players with previous injury history.