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Objective: Data from the Paralympic Games indicate a fluctuating injury incidence in the Paralympic sport goalball, but the mechanisms behind have not been explored. The aims of this study are to (1) quantitatively analyze goalball injuries reported in the London 2012 and Rio 2016 Paralympic Games, (2) qualitatively explain the differences between both games, and (3) qualitatively assess general injury mechanisms and prevention opportunities of injuries in Goalball. Design: This is a mixed-method study. Injury incidence rates were analyzed from data collected during the 2012 and 2016 Paralympic Games. Then, semistructured interviews of games participants qualitatively explored injury mechanisms and prevention opportunities. Results: A reduction of injuries occurred from 2012 (incidence rate, 19.5; 95% confidence interval, 12.5–26.5) to 2016 (incidence rate: 5.6; 95% confidence interval, 1.7–9.5). In both games, acute traumatic injuries were most common. Female athletes reported higher rate of injuries compared with males (P = 0.05). Qualitative data revealed that causes of injuries were collisions, overuse, and poor physical conditioning. The differences between the two games were explained by equipment, environment, and preparations. Conclusions: The result from this study indicates that injuries in goalball are multifactorial. Ultimately, the mixed-method data from this study can help the sports context develop prevention measures. [ABSTRACT FROM AUTHOR]