Study Design: Retrospective case series review. Objective: Participation in athletics is common in high school and college students and presents an increased risk of injury in this age-group. Previous studies have included National Collegiate Athletic Association athletes but not high school athletes. Here we report the trends of maxillofacial injuries in high school students. Methods: Patients presenting to a level 1 trauma center with maxillofacial injuries were identified by chart query with associated International Classification of Diseases, 10th Revision codes for facial fractures between October 2015 and October 2017. Data collected included age, sport, fracture type, need for surgery, associated concussion, and time to return to play were measured. New York State Public High School Athletic Association regional high school sports participation data from 2016 to 2018 were used to calculate incidence. Results: A total of 33 patients aged 13 to 19 years were identified. Baseball, basketball, and lacrosse were most frequently associated with maxillofacial trauma. Annual incidence rates for mandible fractures in high school athletes were 0.037%, 0.012%, and 0.01% for lacrosse, baseball, and basketball, respectively. Annual fracture incidence rates for midface fractures in high school athletes were 0.17%, 0.018%, and 0.01% for baseball, lacrosse, and basketball, respectively. Conclusion: Maxillofacial fractures are uncommon injuries among athletes but present with serious implications including surgical correction. Baseball was strongly associated with midface fractures despite being considered a noncontact sport. Improved facial protection across all sports will be imperative at reducing the incidences of these injuries. Level of Evidence: Level 4.