Background: Ski touring is an outdoor sport with growing popularity in alpine countries. Information about injuries in ski touring is limited. Purpose: To determine injury rates, mechanisms, causes, and risk factors in ski touring. Study Design: Descriptive epidemiology study. Methods: Between November 2015 and May 2016, a total of 191 participants from the Alps region were prospectively tracked via personalized online questionnaires. Injury rates were calculated per 1000 hours of sports exposure. Risk factors were assessed per multivariate logistic regression analysis. Results: A total of 3900 ski tours were performed, with 10,955 hours and 4,108,503 m in height ascension (uphill) recorded. The overall injury rate was 2.5 injuries per 1000 hours of ski touring. A total of 27 injury-events were reported, of which 18 (67%) were classified as mild, 7 (26%) as moderate, and 2 (7%) as severe. Hands (28%) and knees (16%) were the most commonly involved anatomic regions. Most injuries were limited to the soft tissue, such as bruises (31%) and abrasions (18%). Significantly more injuries happened during the descent (n = 17; 63%) than during the ascent (n = 6; 22%) (odds ratio, 5.96; P = .004), while poor weather conditions, icy surface, and inattentiveness were the most often reported reasons for injury. Sidecountry ski touring was identified as the only significant independent risk factor for injury ( P < .001). Conclusion: In this prospective injury surveillance study, the majority of ski touring injuries were mild and limited to the soft tissue. Ski touring injuries were more likely to happen during the descent of a tour, and sidecountry ski touring was the only significant independent risk factor for injury. Bad weather, icy surface, and inattentiveness were found to be the leading causes for an injury-event in this study.