Background: Violence is a frequent occurrence in ice hockey and has been associated with an increased risk of injury. Methods: Case-control study. The study population consisted of youth aged 0-19 years who presented to a participating emergency department (ED) with an injury resulting from participation in ice hockey. In order to examine the outcomes following brain injuries in ice hockey, the outcome was admission to the hospital (cases) or discharge from the ED (controls). In order to examine the relationship between brain injury and violence, the outcome was brain injury (cases) or a non-brain injury (controls). Logistic regression was used to determine the associations controlling for potential confounders. Results: In total, 56,835 youth suffered an injury related to ice hockey. 11.0% (n=6,293) were brain injuries. Youth who engaged in violence were at significantly higher odds of sustaining a brain injury as opposed to an injury to another body part (OR: 1.67; 95% CI: 1.55-1.80). Youth who sustained violence-related injuries were at significantly higher odds of being admitted to the hospital compared to youth who sustained non-violence related injuries (OR: 2.34; 95% CI: 1.49-5.68). Conclusions: Youth who engage in violence are at higher odds of sustaining a brain injury and of being admitted to the hospital.