Background: Ocular trauma represents a significant public health burden and has considerable global epidemiological variation. The epidemiology of ocular trauma in the Northern Cape province of South Africa has not been previously described.Aim: This study aimed to quantify the burden and describe the distribution and determinants of ocular trauma in the Northern Cape province.Setting: The Northern Cape province is the largest, but least populous, of the nine South African provinces. Published data on the health of the Northern Cape population are scarce. Robert Mangaliso Sobukwe Hospital (RMSH) is the only public ophthalmic referral centre in the province.Methods: Hospital record review of all adult cases of acute ocular trauma seen at RMSH over a period of one year (August 2018 – July 2019).Results: Young men comprised the majority of the 240 included cases. Ocular injuries were most likely to occur in the home (n = 115, 47.9%) and on the weekend (n = 159, 66.3%). More than half (n = 135, 56.3%) of all trauma was non-accidental in nature and significantly associated with alcohol use. Accidental trauma (n = 105, 43.8%), predominantly as a result of occupational injuries sustained at work (n = 47, 44.8%) and in the home (n = 45, 42.9%), was deemed largely preventable. Differences in the timing, location and severity of non-accidental and accidental ocular injuries were observed.Conclusion: Ocular trauma in South Africa follows distinct epidemiological trends and is largely because of interpersonal violence, which places strain on limited state healthcare resources.