Regardless of the significant growth of ultra-marathon trail-running races over the last 40 years, epidemiological research is lacking. Presently, no review paper exists that integrates the empirical surveillances of ultra-marathon trail runners' injuries and illnesses. The purpose of this work is to integrate the empirical findings of injuries and illness among trail runners during the period 2007-2016. An electronic database search was conducted using Pubmed, Medline, Science Direct, Ebscohost, Biomed, CINAHL, Embase and Sabinet according to PRIMSA guidelines. The search identified a high injury and illness prevalence among ultra-marathon trail runners. Unfortunately, the injury and illness definition adopted by the studies was heterogeneous, which makes quantifying literature challenging. It is recommended that a homogenous definition of ultra-marathon trail-running injury and illness be drafted. The most prevalent injuries were dermatological (foot blisters, subungual hematoma, chafing and lacerations) followed by musculoskeletal (plantar fascia, ankle, Achilles tendon, knee, lower back and thigh). Common medical illnesses include muscle damage, fatigue, cramps, and cardiorespiratory dysfunction. South Africa hosts a very busy trail-running calendar, but one epidemiological investigation has been conducted among its runners and none in its neighbouring African countries. It is recommended that more quantitative and qualitative investigations be undertaken.