Background <p>To assess the effectiveness of the Wrestling + injury prevention program on incidence of injuries, neuromuscular mechanisms and dynamic balance of freestyle (FS) wrestler.</p> Methods <p>The participants of this study consisted of FS wrestling players in Qom province (Iran). A total of 80 participants were assigned to this study and using simple and random method with computer divided into experimental (EXP, <i>n</i> = 40) and control (CON, <i>n</i> = 40) groups. The groups were blinded against each other. The follow-up period was one season (6 months). EXP replaced their warm-up by Wrestling + program. CON performed a standard warm-up program. The primary outcome was the injury incidence density (injuries per 1000&#xa0;h of wrestling exposure), compared between groups by incidence rate ratios (RR). Also, the secondary outcome was neuromuscular mechanisms and dynamic balance.</p> Results <p>The per-protocol analysis showed a reduction of the overall injury incidence density in the EXP group by 58% compared to the CON group. Additionally, within-group analyses revealed significant improvements in neuromuscular mechanisms and dynamic balance for both the EXP and CON groups following 24 weeks of warm-up programs (<i>p</i> &lt; 0.05). Furthermore, between-group comparisons indicated significant differences favoring the EXP group relative to the CON group (<i>p</i> &lt; 0.05).</p> Conclusion <p>The Wrestling + program is effective in reducing injuries among FS wrestlers with overall injuries reduced by 58%. Moreover, the results indicate that the Wrestling + program is more effective than traditional warm-up routines in improving neuromuscular mechanisms and dynamic balance among FS wrestlers. Therefore, it is recommended that coaches use a Wrestling + program to reduce the incidence of injury in FS wrestlers.</p>