This study was undertaken because of the large number of bicycle accident victims treated in our emergency room. Its aim was to assess the type, frequency, and mechanism of occurrence of bicycle accidents as well as characterization of the type of injuries sustained and the expense incurred by such accidents. One hundred seventy-two patients injured over a 10 month period were studied. The upper extremity was found to be particularly at risk of injury. Fractures accounted for 20% of all injuries. The most common accident mechanisms were being struck by a motor vehicle, falling from a bicycle, or being struck by a bicycle. Eleven percent of the patients studied were pedestrians. Increasing pedestrian-cyclist awareness and modification of currently used protective gloves are proposed to prevent injuries associated with urban cycling.