Dear Editor,With regard to snow-related injuries, winter sports-related injuries, such as snowboarding and skiing injuries have been well investigated.[12] However, there have been few reports about areas where snow is rare.[3] In the Tagata area on Izu peninsula in Japan, hospital is the only one that can treat an injured patient at night; so, almost all injured patients in the area were transported to our hospital. A medical chart review was retrospectively performed for all patients with snow-related injuries who were treated in the emergency room in our hospital from February 8, when a record snowfall hit, to February 11, 2014. The subjects were divided into two groups based on whether they underwent treatments on February 8, 2014 (snowfall day) or on the following days (following days group). There were six cases with a snow-related injury on the snowfall day (one forearm bone fracture, one head injury and lower leg fracture, one head injury and knee wound, one back and knee bruises, two isolate head injuries) and seven cases on the following days (five cases the next day and two cases on the third day; one back bruise, three head injuries, two ankle joint fractures, one head contusion and hip joint sprain). Beginning on the fourth day, there were no patients with snow-related injuries treated in the emergency room. From the snowfall day to the third day, five patients who had injuries due to another mechanism (traffic accident, 2; falling down in a house, 2; received blows to the face, 1) were excluded. There were no significant differences between the two groups with regard to the sex (male/female = 2/4 vs. 2/5), age (the snowfall day vs. the following day: 38.3 + 10.8 vs. 52.8 + 12.2 years old), injury severity score (2.5 + 0.6 vs. 2.0 + 0.5) and admission rate (16.5% vs. 42.8%). In contrast, the number of patients with an injury due to falling objects (5/6 = 83.3%) on the snowfall day was significantly greater than that in the following days group (0/7).This is the first report which demonstrates that injuries due to falling objects increase on the day of a snowfall, whereas slip-related injuries increased on the following days in an area where snow is rare. Ozawa et al. who were orthopedists, reported that the incidence of fractures of the distal radius induced by slipping and falling down in healthy people was high after snowing in Sasebo city where snow was rare.[3] However, this reports that falling objects tend to hit the torso or the head,[45] and Ozawa's report did not describe the treatment of such injuries. Another reason is the deterioration of the buildings in the Tagata area due to the delay in infrastructure redevelopment and repair due to the decreasing birthrate and aging population, and prolonged economic stagnation. This might have led to a lack of integrity of the roof of many building which could not tolerate the heavy snow.