the purpose of this study was to conduct a comprehensive quantitative meta-analysis including a qualitative assessment of studies reporting cross-country skiing injuries. to date there have been three comprehensive review articles on cross-country skiing injuries, yet these studies neglected to demonstrate the importance or statistical significance of specific epidemiological factors. in addition, there has not been a consistent approach to the design of studies that have attempted to describe the type and prevalence of the observed injuries. this meta-analysis considered three epidemiological parameters (body part injured, injury types, and mechanisms of injury) in assessing cross-country skiing. more than 200 articles on cross-country skiing injuries were initially collected and 53 were retained for the meta-analysis. the qualitative analysis of the cross-country skiing injury articles allows us to conclude that the overall quality of the articles collected was adequate but identified some areas of the research as lacking critical information, especially in the description of the skiing conditions, the interacting role of other activities/cross-training with cross-country skiing injuries and the mechanisms of injury involved in this sport. the quantitative meta-analysis was used to summarize the results of the studies and to determine to significance of the proportional estimates of injury types, body part injuries, and the mechanisms of injuries in cross-country skiing. nearly every injury category demonstrated a significant prevalence. this study may provide the framework for future consideration on research design, training and equipment development that underlie injury prevalence in this sport.