Background The Special Olympics Pennsylvania Summer Games attract over 2000 athletes each year. Volunteer medical staff ensures their safety throughout this period. However, few studies have examined the incidence of orthopedic injury and sickness in this group, especially with a large sample. Objective Identify the incidence of orthopedic injury and Illness at the Special Olympics Pennsylvania Summer Games based on demographic criteria and identify the incidence of transports required for advanced care. Methods Data was collected from logs provided by Special Olympics Pennsylvania. The data were analyzed and stratified by gender, age, sport, and type of encounter. We summarized the data and compared it to data from other years and the average. Results An average of 1971 athletes competed annually. On average, 10% (N=144) of competitors required medical care. Males comprised 58.2% (N = 837) of encounters, females 33.6% (N = 483), and in 8.1% (N = 117) of encounters gender was not identified/recorded. The mean age of participants was 29 years of age (range from 10 to 83). 56.6% (N= 813) of encounters required first aid management only. Injuries made up 31.7% (N = 455) of total encounters, and 11.8% (N=169) of encounters were classified as illnesses. Basketball was the sport with the most injuries, 49.5% (N = 711). An average of 9.8 transports was required annually. Conclusions Special Olympics athletes suffer the same injuries as regular athletes, but they are also prone to various medical disorders that regular athletes are not.