Objective:​ To describe the history and methods of the National Collegiate Athletic Association (NCAA) Injury Surveillance System (ISS) as a complement to the sport-specific chapters that follow.

Background:​ The NCAA has maintained the ISS for intercollegiate athletics since 1982. The primary goal of the ISS is to collect injury and exposure data from a representative sample of NCAA institutions in a variety of sports. Relevant data are then shared with the appropriate NCAA sport and policy committees to provide a foundation for evidence-based decision making with regard to health and safety issues.

Description:​ The ISS monitors formal team activities, numbers of participants, and associated time-loss athletic injuries from the first day of formal preseason practice to the final postseason contest for 16 collegiate sports. In this special issue of the Journal of Athletic Training, injury information in 15 collegiate sports from the period covering 1988–1989 to 2003–2004 is evaluated.

Conclusions:​ Athletic trainers and the NCAA have collaborated for 25 years through the NCAA ISS to create the largest ongoing collegiate sports injury database in the world. Data collection through the ISS, followed by annual review via the NCAA sport rules and sports medicine committee structure, is a unique mechanism that has led to significant advances in health and safety policy within and beyond college athletics. The publication of this special issue and the evolution of an expanded Web-based ISS enhance the opportunity to apply the health and safety decision-making process at the level of the individual athletic trainer and institution.