Background: The Registry has collected data on spinal injuries in hockey for 30 years. This paper identifies the nature and incidence of spinal injuries in Canadian ice hockey and the impact of prevention programs. Methods: Data about spinal injuries with and without spinal cord injury in ice hockey have been collected by Parachute Canada/ThinkFirst’s Canadian Ice Hockey Spinal Injury Registry since 1981 through retrospective questionnaires from practitioners, ice hockey organizations and media reports. Injury risk factors assessed include age, gender, location, and injury mechanism. Results: From 1943-2011, 355 cases have been documented. Injuries were primarily sustained by males (97.7%), and were cervical (78.9%)in location, resulting mainly from impact with the boards (64.2%). Checking/pushing from behind (36.0%) was the most common cause of injury, although slightly lower during 2006-2011. Major differences between provinces continue; Ontario and Quebec, continue to show markedly different injury rates, with Ontario’s more than twice that of Quebec. Conclusions: Spinal injuries in hockey continue to occur, although at lower rates than in the peak years from 1981-2000. Injury prevention education and rules reinforcement (e.g. no checking/pushing from behind). Data indicate that multifaceted prevention programs have reduced the risk of injury.