Lacrosse is one of the United States’ oldest and fastest growing sports. Available at adolescent, scholastic, and collegiate levels for both men and women, the sport has become popular among all ages. While the objectives of lacrosse are the same, there are two leagues separated by gender which are functionally different sports in their execution. Men’s lacrosse is a full-contact sport, where each player is required to wear a helmet, mouth guard, and full body pads while on the field. Women’s lacrosse is a non-contact sport that only allows limited “stick checking.” In contrast to men’s lacrosse, female players are only required to wear a mouth guard and sanctioned eye protection. Notably, the helmet is optional in the case of female players. Due to the contact and protection differences in the sport, the incidence of ophthalmic injuries varies when comparing men’s and women’s leagues. Of head injuries sustained by female players, a higher proportion are injuries to the periorbital region. In contrast, most head injuries reported among boy and men players are concussions. Beyond the presentation of injuries, the mechanism of injuries varies between the two sports, with male players typically receiving injuries from body contact and female players from equipment contact. These relationships are important to study, as they have led to safety and regulation changes. This chapter hopes to highlight these relationships, while also providing reference for how ophthalmologists can continue to combat ocular disturbances attributed to the lacrosse field.