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Jeju Island is the most visited spot in South Korea; however, it had the highest death rate in the country due to injury in 2008. We investigated injured patients who presented to an emergency department (ED) in Jeju and compared patients who were visitors with those who were residents of Jeju. A retrospective study was conducted on injured patients visiting the ED at the Jeju National University Hospital from March 2008 to February 2010. The following factors were investigated: demographic data, new injury severity score (NISS), alcohol use, intention of injury, mechanism of injury, place of occurrence, activity when injured, patient outcome, and final mortality. A total of 9,226 injured patients visited the ED during the study: 8,392 residents and 834 visitors (9.04%). The sex ratio and NISS were not different between the two groups. The mean age was younger in visitors (33.96 ± 23.37 vs 30.83 ± 18.79, p < 0.001). More intentional injuries and alcohol-related injuries occurred in residents than visitors ( p < 0.001 and p < 0.005, respectively). In both groups, the most common reasons for injury were falling, stumbling, jumping, and being pushed. Visitors had more transportation-related injuries and were injured more often during leisure or play or when traveling. Injuries to visitors occurred more often in commercial, countryside, recreational, and cultural areas. Forty-three deaths were reported, including two visitors who died from suffocation and drowning. To prevent accidents, safety information should be provided for visitors and injury prevention education should be provided for students on school trips and tour guides. Legislation should be passed on the use of protective equipment for motorcyclists and bicyclists. These results support taking measures to decrease the rate of injury among visitors on Jeju Island. [ABSTRACT FROM AUTHOR]