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Study Objectives: Stingray injuries result in thousands of emergency department visits annually. The most abundant stingray in our locale is the round ray, Urobatis halleri. This study aimed to assess the true complication rate following stings from these stingrays, as well as describe the outcome of treatment with hot water submersion. Methods: This was an on-site, prospective, observational study, in which subjects were enrolled among beach-goers from a Southern California coastal site. Subjects were consenting participants and were eligible for inclusion if they had been inflicted with a new stingray injury and were 7 years or older. Standard treatment by lifeguards is to submerge the wound in water heated to 108-113 degrees F until pain has reasonably subsided as determined by the affected individual. Lifeguard preference dictated use of topical povidone-iodine prior to submersion. A trained researcher conducted an enrollment survey to obtain the following information: age, sex, health conditions, and medications. Researchers also examined the wound to provide a general description of the injury and judge the presence or absence of foreign bodies. Duration of hot water submersion and pain score measured on the NRS-11 scale of 0-10 before and after treatment were recorded. Patients were contacted via telephone survey on post-injury days 3, 7, and 14 to assess pain score and any ongoing symptoms, treatments, or complications of their injury. Results: A total of 22 subjects (male n¼17) were included in the study, mean age was 29.7 years. Wound types were classified as puncture (n¼12) and laceration (n¼10). Mean wound length was 8.6mm (range¼2-20mm). All injuries were distal lower extremity and without foreign bodies. There were no identified medical issues or concurrent antibiotic use among subjects. 10 subjects were treated with hot water submersion and povidone-iodine, 12 with hot water submersion alone. Ongoing symptoms included mild pain, erythema, edema, and pruritus around the wound. These symptoms were noted at 3-day follow-up in 6 of 22 patients (27.3%); all but one of these subjects had resolution with conservative treatment by day 7 and remained well on day 14. The one subject with an ongoing complication developed increased swelling, erythema, and purulence diagnosed as cellulitis by his primary care physician on post-sting day 8, which was treated with antibiotics to resolution. Minor complications were seen more commonly in patients treated with hot water and povidone-iodine (5 of 10) when compared with those treated with hot water alone (p¼0.056). There was a significant difference in wound size between those with and without ongoing symptoms at 3-day follow-up (p¼.0102) using a t-test. This significance was confirmed using a linear discriminate analysis (p¼.010). No wounds less than 1 cm long developed any minor complications. Average duration of water submersion was 73.6 minutes (range 35-145 minutes). Mean pain score pre-treatment was 7.36 and post treatment was 2.18, with an average decrease of...