To assess the effectiveness of chiropractic interventions for the treatment and/or prevention of sports injuries. Five electronic databases were searched through to March 2011. All controlled clinical trials investigating the effectiveness of chiropractic manipulation for the treatment and/or prevention of sports injuries in human subjects were considered. Study selection, data extraction, and validation were performed independently by two reviewers. Four RCTs and two CCTs met the inclusion criteria. The methodological quality of the included RCTs was poor, with Jadad scores ranging between zero and three. One RCT and two CCTs suggested that chiropractic was an effective treatment for sports injuries. Two RCTs indicated that there was no difference between chiropractic and control groups in the treatment of sports injuries. One RCT suggested that chiropractic was not effective for the prevention of sports injuries. Few rigorous trials have tested the effectiveness of chiropractic manipulation for the treatment and/or prevention of sports injuries. Thus, the therapeutic value of this approach for athletes remains uncertain.