Introduction <p>Sports events attract large crowds, necessitating the provision of medical services. Medical issues at these events can include acute injuries, such as falls or incidents related to the sport being played, as well as the worsening of pre-existing health conditions.</p> Study objective <p>The aim of this descriptive study is to report on the extent and type of spectator medicine services needed during major sporting events in ice hockey and what factors affected the use of these services.</p> Methods <p>Data was collected from two top-level men’s world championship tournaments in Finland consisting of 98 games with a total of over 630,000 spectators. Trained nurses working in pairs reported the type, treatment and time of day of spectator medicine services provided at the tournaments, as well as the number of patients requiring treatment outside the arena.</p> Results <p>The average number of health care contacts per game was 3.9. The number of health care contacts increased in concordance with audience size, but when adjusted for audience size there were fewer contacts in host team Finland’s games (0.55, 95% CI 0.3–0.9). 30% of the contacts were due to skin conditions, followed by musculoskeletal conditions and headaches. A total of 25 patients required treatment outside the arena, with 9 requiring an ambulance transfer.</p> Conclusion <p>The preparatory measures and the number of medical staff present were at times abundant, but nevertheless sufficient for the needs of the spectators. This resulted in only a small minority of patients needing to be transferred for further treatment outside the arena. For future events, we recommend there is at least one nurse for every 1000 expected spectators. Additionally, nurses should work in pairs to be able to effectively initiate treatment for severe medical conditions.</p> Clinical trial number <p>Not applicable.</p>