This study aimed to examine the relationship between the trunk impairment level and the trunk kinematic characteristics during alpine sit-skiing from a classification perspective. Three Paralympic medalists in sitting classes (LW10-2, LW11, and LW12-2) participated in the present study. To simulate the racing conditions, giant slalom gates were set. To measure the kinematics of the skier and sit-ski during skiing, a motion capture method with inertial measurement units was used. The muscle activities of the trunk muscles were evaluated using electromyography. Chest lateral flexion, chest flexion, and hip flexion/extension angle during sit-skiing were reduced due to impairment. Additionally, the insufficient lateral flexion (angulation) caused a decrease in edging angle, and that the insufficient chest and hip flexion/extension caused a lower loading in the latter half of the turn through smaller vertical movement. Since edging angle and loading are key factors in ski control, the three joint motions could be measures of sport-specific activity limitation in sit-skiing classification. Between the LW10-2 and LW11 skiers, no distinct differences in trunk kinematics were found. Assuming the scaling factor of race time as a measure of skiing performance, one possible reason is that the difference in skiing performance the LW10-2 and LW11 skiers is considerably smaller relative to differences between the LW11 and LW12-2 skiers. There were no distinct differences among classes in the results of muscle activity, and therefore, this information appears to play a minimal role for classification.