Background: Alpine ski racing is a popular international winter sport that is complex and challenging from physical, technical, and tactical perspectives. Despite the vast amount of scientific literature focusing on this sport, including topical reviews on physiology, ski-snow friction, and injuries, no review has yet addressed the biomechanics of elite alpine ski racers and which factors influence performance. In World Cup events, winning margins are often mere fractions of a second and biomechanics may well be a determining factor in podium place finishes. Objective: The aim of this paper was to systematically review the scientific literature to identify the biomechanical factors that influence the performance of elite alpine ski racers, with an emphasis on slalom, giant slalom, super-G, and downhill events. Methods: Four electronic databases were searched using relevant medical subject headings and key words, with an additional manual search of reference lists, relevant journals, and key authors in the field. Articles were included if they addressed human biomechanics, elite alpine skiing, and performance. Only original research articles published in peer-reviewed journals and in the English language were reviewed. Articles that focused on skiing disciplines other than the four of primary interest were excluded (e.g., mogul, ski-cross and freestyle skiing). The articles subsequently included for review were quality assessed using a modified version of a validated quality assessment checklist. Data on the study population, design, location, and findings relating biomechanics to performance in alpine ski racers were extracted from each article using a standard data extraction form. Results: A total of 12 articles met the inclusion criteria, were reviewed, and scored an average of 69 ± 13 % (range 40-89 %) upon quality assessment. Five of the studies focused on giant slalom, four on slalom, and three on downhill disciplines, although these latter three articles were also relevant to super-G events. Investigations on speed skiing (i.e., downhill and super-G) primarily examined the effect of aerodynamic drag on performance, whereas the others examined turn characteristics, energetic principles, technical and tactical skills, and individual traits of high-performing skiers. The range of biomechanical factors reported to influence performance included energy dissipation and conservation, aerodynamic drag and frictional forces, ground reaction force, turn radius, and trajectory of the skis and/or centre of mass. The biomechanical differences between turn techniques, inter-dependency of turns, and abilities of individuals were also identified as influential factors in skiing performance. In the case of slalom and giant slalom events, performance could be enhanced by steering the skis in such a manner to reduce the ski-snow friction and thereby energy dissipated. This was accomplished by earlier initiation of turns, longer path length and trajectory, earlier and smoother application of ground reaction forces, and carving (rather than skidding). During speed skiing, minimizing the exposed frontal area and positioning the arms close to the body were shown to reduce the energy loss due to aerodynamic drag and thereby decrease run times. In actual races, a consistently good performance (i.e., fast time) on different sections of the course, terrains, and snow conditions was a characteristic feature of winners during technical events because these skiers could maximize gains from their individual strengths and minimize losses from their respective weaknesses. Limitations: Most of the articles reviewed were limited to investigating a relatively small sample size, which is a usual limitation in research on elite athletes. Of further concern was the low number of females studied, representing less than 4 % of all the subjects examined in the articles reviewed. In addition, although overall run time is the ultimate measure of performance in alpine ski racing, several other measures of instantaneous performance were also employed to compare skiers, including the aerodynamic drag coefficient, velocity, section time, time lost per change in elevation, and mechanical energy behaviours, which makes cross-study inferences problematic. Moreover, most studies examined performance through a limited number of gates (i.e., 2-4 gates), presumably because the most commonly used measurement systems can only capture small volumes on a ski field with a reasonable accuracy for positional data. Whether the biomechanical measures defining high instantaneous performance can be maintained throughout an entire race course remains to be determined for both male and female skiers. Conclusions: Effective alpine skiing performance involves the efficient use of potential energy, the ability to minimize ski-snow friction and aerodynamic drag, maintain high velocities, and choose the optimal trajectory. Individual tactics and techniques should also be considered in both training and competition. To achieve better run times, consistency in performance across numerous sections and varied terrains should be emphasized over excellence in individual sections and specific conditions. [ABSTRACT FROM AUTHOR]