Objectives: Compared to other athletic activities, research on injury incidence and risk factors in dance is limited. There is also a need for more research evaluating the impact of intense training on elite adolescent athletes. The aim of this study was to evaluate the rates and risk of injuries, the hours of dance exposure and the characteristics and consequences of injuries among elite pre-professional ballet students. Design: Prospective epidemiological study. Methods: 266 (112 male) full-time students aged 15-19 years from three elite pre-professional ballet schools were followed prospectively over one school year. Injury rate was reported per 1000. h of dance and 1000 dance exposures (DEs). Injury details collected included type and anatomical location of injury. Results: The clinical incidence of injury was 1.42 injuries per dancer and the risk of injury was 76 over the one-year period. The rate of injury was 1.38/1000. h of dance and 1.87/1000 DEs. Joints were the most commonly injured structures and the ankle was the most commonly injured body area. Overuse injuries were more common than traumatic injuries. Bony injuries (e.g. stress fractures), and injuries to the knee were associated with the greatest time loss per injury. Injury risk and rate increased as students progressed through their three years of training. Conclusions: In comparison with other adolescent athletic populations, participants in this study had a similar injury rate but a higher risk of injury. This may be attributable to the high level of training exposure in pre-professional ballet students.