A safe sport is a bit of an oxymoron: competition puts a severe strain on the vital systems of the organism that may be dangerous or uncontrollable, does not come in small doses and entails unpredictable results. Sports injury surveillance aims to estimate the impact of different factors that increase the risk of injuries and to elaborate wise and efficient measures to curb this risk. Accurate data on mortality rates in athletes help to improve approaches to health screening. Injury surveillance systems that also report injury-related deaths in athletes exist in many developed countries. This article talks about sports injuries in Russia and provides rationale for creating a nation-wide system of sports injury surveillance.