Skiing and snowboarding are popular winter sports associated with significant traumatic spinal injuries. Despite a decline in most injuries related to these sports over the years, acute injury rates of the spine have remained stable and even increased. Vertebral fractures and spinal cord injuries are the most common serious acute injuries of the spine in skiers and snowboarders. Due to the unique characteristics of each sport, different injury mechanisms are responsible for the majority of injuries. This article reviews injury patterns, injury types, mechanisms of injury, and strategies for prevention of spine injuries in skiers and snowboarders.