The recreational use of trampolines is widespread and growing rapidly around the world. The reported incidence of significant injuries continues to increase despite more than three decades of attempts to educate the public on the inherent dangers of trampolines and appropriate safety rules for their use. Competitive trampolining also is growing, although there is scant medical literature related to training issues and injuries to assist the physician in guiding and treating these athletes. It is anticipated that with the increased use of trampolines and with the evolution of ever more complex competitive techniques and routines, the potential for catastrophic injuries in competition will increase. This article discusses awareness of the risks and attempts to mitigate injuries. It remains unclear, from an injury risk standpoint, whether trampolines can be used with an acceptable degree of safety.