Our goal is to optimize the level of medical care delivered to riders on the tour in a comprehensive way. Participation of local EMS squads and advance planning is essential for providing acute, prompt medical care at the scene and to provide transport to local or distant hospitals to evaluate or treat more serious conditions. Fortunately the majority of injuries is minor, but when EMS personnel and physicians work closely together, riders and tour staff feel more comfortable with concerns about their health during the event. Based on our experience, we have made suggestions for preventing injuries and have provided a framework for the physician interested in effectively delivering medical care at any recreational cycling event.