Context: Professional horse racing is considered a high-risk sport, yet the last analysis of fall and injury incidence in this sport in Ireland was completed between 1999 and 2006.Objective: To provide an updated analysis of the fall and injury incidence in professional flat and jump horse racing in Ireland from 2011 through 2015, compare it with the previous analysis, and detail the specific types and locations of injuries.Design: Descriptive epidemiology study.Setting: A medical doctor recorded all injuries that occurred at every official flat and jump race meeting for the 2011 through 2015 seasons using standardized injury-report forms.Main Outcome Measure(s): Injury and fall rates and their 95% confidence intervals (CIs) were reported for flat and jump racing. Incidence rate ratios and 95% CIs were calculated between flat and jump racing, between the 1999-2006 analysis and the current results, and between 2011 and 2015. The distribution of injuries for type and location of injury was reported.Results: Compared with flat racing, jump racing had significantly more falls per 1000 rides (49.5 versus 3.8), injuries per 1000 rides (10.1 versus 1.4), and injuries per 1000 meetings 776.0 versus 94.1). However, the rate of injuries per 1000 falls was significantly higher in flat racing (352.8 versus 203.8). An increase in injuries per 1000 falls between 2011 and 2015 was found in flat racing (P = .005). Since the previous analysis, a significant increase in injuries per 1000 rides and falls was noted in jump racing. Soft tissue injuries were predominant in flat and jump racing (61.54% and 68.80%, respectively), with fractures the second most common injury (15.38% and 18.06%, respectively). Concussions were more prevalent from flat-racing falls (incidence rate ratio = 0.30; 95% CI = 0.15, 0.61). The lower limb was the most frequent location of injury (32.89%) in flat racing; however, in jump racing, upper limb injuries (34.97%) were predominant.Conclusions: An update on professional flat-and jumpracing fall and injury epidemiology is provided. Further research to identify risk factors for injury, design and investigate the feasibility of injury-prevention strategies, and document their effects on fall and injury incidence is required.