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Background: Little is known about the characteristics of emergency patients transported to hospital while participating in sports activity. Hence, we identified characteristics of emergency patients transported to hospital by emergency medical service (EMS) while participating in sports activity in Osaka City., Methods: Population-based ambulance records of Osaka Municipal Fire Department were reviewed. All sports-related emergency transport cases (ie, patients experiencing external injury or illness during/immediately after participation in sports activity and then transported to hospital by the EMS) were enrolled, including both athletes and recreational sports participants. The study was performed from January 1, 2013 to December 31, 2015. Data of patient characteristics were described according to the type of sports., Results: During the study, 661,190 patients required emergency transport in Osaka city; 2,642 (0.4%) were sports-related emergency transport, including 2,453 external injuries and 298 illnesses. Overall, 79.0% of patients were men and 44.4% were less than 18 years. Emergency transport during ball games accounts for the majority of cases (71.5%, 1,888/2,642), including baseball (n = 380), soccer (n = 368), and futsal (n = 209). The leading diagnosis/symptom of external injury was fracture/bone contusion (n = 701) and that of illness was heatstroke/dehydration (n = 184). Serious acute illness, such as sudden cardiac arrest, accounted for 0.6% (16/2,751) of all accidents, with half of them (n = 8) related to long-distance running., Conclusion: Characteristics of sports-related accidents widely varied by type of sports. Measures to prevent serious accidents during sports activities should be established based on the information on patient characteristics of each type of sports.