Participation in martial arts has grown over the past 15 years with an estimated 8 million participants. In 2004, the Chief of Staff of the Army directed that all Initial Military Training soldiers receive Modern Army Combatives (MAC) training. The mechanical differences between the various martial arts styles incorporated into mixed martial arts/MAC pose challenges to the medical professional. We report the incidence of musculoskeletal injuries by Level 1 and 2 trained active duty soldiers participating in MAC over a 3-year period. From June 1, 2005 to January 1, 2009, the Orthopaedic Surgery service treated and tracked all injuries in MAC. Data was analyzed using the Chi(2) method of analysis. (p < 0.05). 155 of 1,025 soldiers presenting with MAC injuries reported inability to perform their military occupation specialty duties. The knee was most frequently injured followed by shoulder. Surgical intervention was warranted 24% of the time. Participants in MAC reported injuries severe enough to impact occupational duties at 15.5%. Surgical intervention was warranted only 24% of the time. The knee and shoulder are the most frequently injured body parts. Labral repair was the most frequent surgical procedure.