A one-year prospective survey was conducted to study the incidence of and potential risk factors for farm-related injuries in Eastern Ontario. One hundred and seventeen dairy and beef farms were surveyed using a personal interview. Information was collected on demographic characteristics of the farm owners, workers, and families; characteristics of the farm operations; and information on behaviors potentially affecting injury risk. Monthly telephone contact was then maintained with the farms for one year in order to document all farm-related injuries. Overall and specific injury rates were calculated. Treatment patterns for these injuries were described. The statistical significance of several potential risk factors for injury was evaluated; assessment of relative risk estimates (RR) and adjustment for confounding factors was done using logistic regression analysis. The overall farm injury rate was 7.0 persons injured per 100 person-years (95% C.I.: 4.9,9.1, n = 547). Common patterns of injury by ICD-9-E-Code included accidents caused by farm machinery (E919.0), accidental falls (E880-8), and injuries caused by animals (E906). Variables found in multivariate logistic models to be predictive of injury occurrence were living on a beef farm (RR = 2.5; p = 0.01); increased farm work experience (trend: p less than 0.01); full-time exposure to farm work (RR = 2.5; p = 0.04); and, in farm owners, the use of prescriptions medications (RR = 2.7; p = 0.07). Forty-six percent of the farm-related injuries were treated in a hospital-based emergency department (ER). Efforts to monitor the incidence of farm injuries using an ER-based information system have the potential to significantly under-estimate the scope of the regional farm injury problem in Eastern Ontario.