PURPOSE:An original case of rectal injury after a personal watercraft accident is reported. Principles of rectal trauma management are discussed.METHODS:We present a case of a rectal injury after a fall from a personal watercraft. Rigid sigmoidoscopy and a water‐soluble contrast enema documented a posterior rectal tear. The patient was managed by diversion, drainage, and administration of antibiotics.RESULTS:The patient's rectal tear healed without complication.CONCLUSION:To our knowledge, this is the first reported case of an injury to the rectum as a result of a personal watercraft accident. A high suspicion of rectal injury must be maintained in victims who have fallen from the back of a personal watercraft. Treatment of a rectal injury should follow the basic principles of drainage, diversion, and administration of antibiotics, but variations in traditional management may be appropriate. Finally, preventative methods including wearing protective clothing, and possible modification to the watercraft to reduce risk of injury should be considered.