Context Point-to-point racing may place jockeys at risk of serious injuries due to the high incidence of falls as previously reported. Despite many advances in health and safety strategies, the incidence of falls and injuries in point-to-point racing has not been reported since 2006. Objectives To provide a longitudinal analysis of the fall and injury incidence in point-to-point horse racing jockeys in Ireland from 2007 to 2015 and compare these findings with the previous literature. Design Descriptive epidemiologic study. Setting All injuries that occurred due to a fall at every official point-to-point race meeting from 2007 to 2015 were recorded by a medical doctor using a standardized injury report form. Main Outcome Measure(s) Falls and injury rates and their 95% confidence intervals were calculated. Incidence rate ratios (IRRs), 95% confidence intervals and percentage change were compared between point-to-point and professional racing, between previous data and the current results, and from 2007 to 2015. Results An average of 67.40 injuries/1000 falls and 9.08 injuries/1000 rides occurred in point-to-point racing, and this was reduced compared with the previous analysis. Amateur jockeys sustained an overall mean of 134.77 falls/1000 rides and the yearly means decreased over the 9 years of the study. Amateur jockeys sustained a higher fall rate than professional jockeys (flat: IRR = 35.47 [31.03, 40.54]; jump: IRR = 2.72 [2.63, 2.82]); however, their injuries/1000 falls rate was lower (flat: IRR = 0.19 [0.15, 0.24]; jump: IRR = 0.33 [0.30, 0.63]). Soft tissue injuries were predominant (43.09%), with 26.06 fractures and 9.98 concussions/1000 falls occurring. Conclusions Although injuries have been reduced since the previous analysis, more serious injuries such as fractures and concussions were more common in point-to-point racing than professional racing, possibly due to their higher fall risk. Thus, identifying strategies to reduce the fall risk in point-to-point racing should be a priority.