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Background: Powered parachutes are becoming a popular form of sport flying. No previous study has reviewed injuries in this sport. The purpose of this study was to describe the injuries associated with powered parachute flying, the flight factors involved in an incident, and the impact an incident has on current sport involvement., Methods: National Transportation Safety Board incident reports involving powered parachutes between 2004 and 2015 were reviewed. Internet searches were performed to contact involved pilots to find further information., Results: There were 71 incidents reported involving 117 people. Of these, 10 incidents involved 14 fatalities (12.0%). Of the 14 fatalities, 11 (78.5%) occurred in midflight. Pilot error was the most common finding for an incident and accounted for 53/71 incidents (74.6%). The main error was misjudging the distance required for takeoff and landing. This accounted for 37/71 incidents (52.1%). Orthopedic extremity injuries were the most common severe injuries reported. Surgical intervention was needed in 43.8% of injuries and 48.0% of those involved fractures. The median return to work was 14 d (range 0-180 d). Only 4/53 (7.5%) of the pilots contacted continued to fly powered parachutes., Discussion: Powered parachute participants are at risk for unique injuries compared to other forms of flight. A powered parachute injury can have a significant impact on future pilot involvement in the sport. This study provides evidence for design changes in the aircraft and helps direct pilot training. This information can improve the safety and well-being of participants so they can continue to fly powered parachutes. Skelley NW, Yarholar LM, Richardson LC. Pilot and passenger injuries associated with powered parachutes. Aerosp Med Hum Perform. 2016; 87(11):947-953.