Sailboarding is an exciting sport, but it does involve some risk for injury. In this study of 21 knee injuries that occurred during sailboarding over a 2-year period, 12 were isolated medial collateral ligament (MCL) sprains, 4 were meniscus tears, and 5 involved joint instability. The MCL sprains were directly related to the use of the foot straps on the sailboard. Conservative treatment was successful for the MCL sprains; the meniscus tears were treated with arthroscopic surgery. Improved foot straps designed to release the foot more readily may help reduce knee injuries.