The objective of this research was to investigate the sociodemographic, psychosocial, behavioural and emotional risk factors associated with self-reported major injuries.A case-control study, nested in a two-stage survey, was carried out in two cities of the Distrito Federal, Brazil. Cases were defined as subjects who reported an event resulting in injury or physical harm to the person, about which a hospital was visited or a doctor consulted (major injury), during the period of 6 months preceding the interview. Controls (n=640) were matched to cases (n=231) based on sex and neighbourhood. Information on determinants of injuries was collected by self-completed questionnaires and included sociodemographic, psychosocial, behavioural and emotional variables. Data analysis used conditional logistic regression models.Controlling for social support and pro-social behaviour, adolescents reporting “abnormal” behaviour and emotional problems had more than three times the chance of reporting a major injury compared to “normal” status adolescents (OR=3.65, 95%CI=1.83–7.32).The findings of this study suggest that preventive strategies, while addressing the broader community and environmental risk factors for injuries, need to address the behavioural and emotional factors associated with these injuries.