BACKGROUND: Injuries due to falling coconuts are a common yet underreported form of trauma in the tropical regions. Although these might appear insignificant at first glance, the physical forces involved are potentially fatal. Despite their global prevalence, research on this subject remains scarce, making it a neglected public health concern. This study seeks to bridge these gaps by analysing the affected demographics, contributing factors and injury patterns. By enhancing the understanding of coconut fall-related injuries, this research seeks to create awareness about dangers of falling coconuts and inform the development of effective public health strategies to mitigate their impact. METHODS: A retrospective study was conducted over a period of 3 years from January 2021 to December 2023 at a tertiary care centre on the southern coast of India. Patients who presented to emergency with coconut-fall related injuries were identified through a comprehensive review of nursing ledgers. Additional data including imaging, consultations & treatment details were retrieved from patient files and electronic medical records. Descriptive statistics of the recorded data like demographic variables, time of injury, injury patterns, injury severity score (ISS) and ED disposition were analysed by using Microsoft Excel 365. RESULTS: The study population included 17 males and 12 females. Most patients were within the age group of 40-60, which comprised 48% of the total participants. The months of September and October reported the highest frequency of cases. Out of the 29 patients, 14 were farm workers who sustained coconut fall-related injuries. Injury patterns varied from mild soft tissue injuries to severe TBIs which include SDH and SAH. There were 3 patients who required surgery, and 7 patients were admitted. There were no fatalities reported, and average hospital stay was 4.5 days. CONCLUSION: Coconut fall-related injuries in tropical regions is a significant but less recognised public health issue. Our study shows the necessity of seasonal preventive strategies, public awareness and safety measures for high-risk population like outdoor workers and older adults. Community focussed interventions, such as regular coconut tree pruning, installation of coconut safety nets and educational campaigns will help to reduce the incidence and severity of these injuries.