Advancements in technology and the economic desires to maximize use of athletic playing surfaces have led to the development of various playing surfaces across the spectrum of sports. Each of these surfaces possesses specific safety profiles which are sport and population specific. Despite the growing medical literature on outdoor playing surfaces, inconsistent data exist on both orthopedic injuries and general medical concerns, such as surface component exposure toxicity and infection risk. Unfortunately, there is a paucity of data regarding various indoor playing surfaces and their effects on injury risk; this is an area ripe for further medical investigation. Understanding the differences in various play surfaces and their associated injury and health concerns is crucial for all medical staff providing care to athletes across the spectrum of skill and competition.