Abstract Background In girls who present with vaginal trauma, sexual abuse is often the primary diagnosis. The differential diagnosis must include patterns and the mechanism of injury that differentiate accidental injuries from inflicted trauma. Case A 7-year-old prepubertal girl presented to the emergency department with genital bleeding after a serious accidental impaling injury from inline skating. After rapid abduction of the legs and a fall onto the blade of an inline skate this child incurred an impaling genital injury consistent with an accidental mechanism. The dramatic genital injuries when repaired healed with almost imperceptible residual evidence of previous trauma. Summary and Conclusion To our knowledge, this case report represents the first in the medical literature of an impaling vaginal trauma from an inline skate and describes its clinical and surgical management.