BACKGROUND: Tree stands have remained popular among hunters because of the increased vantage point for the hunter. Although stand styles vary, the typical stand is very minimalistic in design, comprising a seat and an area for the hunter to place his feet. Although there have been studies using state trauma registry data, to date, there has not been a study on the epidemiology of tree stand-related injuries in the national population. METHODS: The 2000 to 2007 National Electronic Surveillance System provided information among individuals aged 16 years and older regarding tree stand-related injuries that required emergency room attention in the United States. Hunter population estimates from the U.S. Fish and Wildlife Services were used to estimates injury rates by sex, age, race, month, and year. RESULTS: The rate of tree stand-related injuries remained relatively stable from 2000 to 2007. Rates were higher for men compared with women (48.0 vs. 24.7 per 100,000 hunters, respectively) and highest among those 15 to 24 (55.7 per 100,000) and 25 to 34 (61.0 per 100,000). CONCLUSIONS: Although a majority of hunters are older, the highest rates occurred among the younger ones. Hunters using and manufacturers of tree stands must be aware of the safety precautions during use of the stands. Improvements in the safety design of the stands as well as knowledge to the proper use of stands can help to minimize the burden of injury in the hunter population related to tree stands. Copyright © 2010 by Lippincott Williams & Wilkins.