Is soccer-related injury the major cause of elite soccer players being unable to train and play during the competitive season?The aims of this study were to utilise comprehensive data to quantify the cost, in terms of loss of training and match availability, of all absences and to determine if injury is the major cause of absence.Descriptive epidemiology.All players (n=55) (Mean±SD; age, 24±5; height, 179cm±9; weight, 82kg±7.4) at an English Division One soccer club had their attendance and absence recorded on a comprehensive daily register throughout the two seasons 2003/2004 and 2004/2005. An absence was defined as an inability to train with the rest of the squad or play competitive first team matches irrespective of the cause.A total of 110 competitive matches and 287 squad training sessions were recorded generating 2604 and 10740 exposure hours, respectively. Individual absences totalled 378 for first team matches and 1441 for training sessions. Reportable injuries accounted for 49% of first team match unavailability and 60% of training sessions missed. Other health-related problems accounted for more than one in four and suspensions almost one in seven of missed matches.Soccer-related injury is the major single factor affecting player availability. However, strategies to maximise player availability by targeting player discipline and general health initiatives may also be effective in reducing unavailability.