Sports at high altitudes require special consideration when it comes to medical management of participating athletes. For many popular mountain-based sports, including skiing, snowboarding, climbing, mountaineering, snowmobiling, mountain biking, and more, there are distinct injury patterns that are important to recognize. Knowledge of the symptoms and treatment of high-altitude illness (HAI) is crucial for athletes ascending to high elevations, with the most important preventive measures being acclimatization and gradual ascent. Accommodation for inclement weather patterns and the use of proper equipment are also paramount. Mountainous regions are rugged environments with varied terrain, which complicates extraction operations and necessitates special certification for first responders.