Participation in ultramarathons has become increasingly popular especially among nonelite athletes. Ultramarathons have a wide spectrum of race characteristics from the variety of distances to environmental factors. Ultramarathons continue to attract a relatively small number of participants who on average are more experienced than marathon runners. There are limited epidemiologic studies on common ultramarathon injuries and illnesses. Musculoskeletal and dermatologic problems are very common among ultramarathoners. Each ultramarathon is unique, and medical directors should try to establish an injury surveillance system in order to be better prepared for possible medical conditions. The focus of this article is on the evaluation and management of common medical conditions encountered during ultramarathons.