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Play is widely acknowledged to provide children with various physical, emotional, social, and intellectual benefits. However, playgrounds are reported to be the leading location of unintentional recreation injuries to children aged 1-10. Over 185,000 children annually are being treated in emergency departments for playground injuries. These play-related injuries have remained stagnant according to epidemiology studies of the past three decades. Past epidemiological studies for playground injuries have been based on emergency department data, resulting in an underrepresentation of the magnitude of injuries occurring. This study utilizes the unique setting of an entire school district, providing a more comprehensive understanding of injury patterns on playgrounds. The data in this study is useful for interpreting injury patterns in the context of existing safety standards and guidelines for playgrounds. Playground injury mitigation efforts are based largely on current epidemiological studies derived from emergency department databases. Thus, efforts focus on the prevention of severe head injuries. This study has established an 88% incident rate outside of severe playground injuries within the school district. Analysis has shown that upper extremity injuries are twice as likely to require outside medical attention as injuries to other body regions, including the head and neck. These findings may indicate that there are gaps in current injury mitigation efforts that should be addressed by standards and guidelines organizations. Given what is known about playground injury patterns from past studies, and new data from the epidemiology of the current study, recommendations can be made to enhance the safety of childhood play.