Since the inception of pickleball in 1965, approximately 19% of the US population has engaged in the sport. Although pickleball was initially intended as a safe activity for children, the vast majority of players are older adults. Within the last 5 years, there has been a conspicuous surge in pickleball-related injuries. The objective of this review is to explore the literature on head and neck injuries associated with pickleball. In studies published from 2018 through October 2025, the reported incidence of head and neck injuries arising from participation in pickleball activities ranged from 2.6% to nearly 20%, mainly involving trauma to the face and eyes. Severe injuries to the head included concussion, affecting 15% of children and 0.5% of adult players, with isolated cases of nasal, orbital, skull, and mandibular fractures. Five pickleball-related deaths were also recorded. With the increasing number of individuals playing pickleball, it remains likely that oral healthcare providers will assess patients with sports-related head and neck injuries and possible traumatic brain injury. To reduce the incidence of injury to the head and neck, clinicians should recommend the use of assorted protective equipment, particularly eyewear, a mouthguard, and a helmet.
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