In briefThis review of 12 paragliding accidents in the Aspen, Colorado, area over a nearly 2-year period identifies causative factors and common mechanisms of injury and assesses the nature and severity of the injuries. Pilot error in judgment was the most frequent cause of accident. Lower-extremity and spinal compression fractures are common during forceful landings. Free-fall accidents, however, typically cause more serious pelvic, chest, and abdominal trauma.