OBJECTIVES : To describe the incidence of injury in the pre-competition and competition periods of the Rio 2016 Summer Paralympic Games. METHODS : A total of 3657 athletes from 78 countries, representing 83.4% of all athletes at the Games, were monitored on the web-based injury and illness surveillance system over 51,198 athlete days during the Rio 2016 Summer Paralympic Games. Injury data were obtained daily from teams with their own medical support. RESULTS : A total of 510 injuries were reported during the 14 day Games period, with an injury incidence rate (IR) of 10.0 injuries per 1000 athlete days (12.1% of all athletes surveyed). The highest IRs were reported for football 5-a-side (22.5), judo (15.5) and football 7-a-side (15.3) compared with other sports (p < 0.05). Pre-competition injuries were significantly higher than in the competition period (risk ratio: 1.40, p < 0.05), and acute traumatic injuries were the most common injuries at the Games (IR of 5.5). The shoulder was the most common anatomical area affected by injury (IR of 1.8). CONCLUSION : The data from this study indicate that a) IRs were lower than those reported for the London 2012 Summer Paralympic Games, b) the sports of football 5-a-side, judo and football 7-a-side were independent risk factors for injury, c) pre-competition injuries had a higher IR than competition period injuries, d) injuries to the shoulder were the most common injuries. These results would allow for comparative data to be collected at future editions of the Games and can be used to inform injury prevention programs.