Rock climbing, sport climbing and bouldering are highly popular new sport disciplines. An increasing number of indoor climbing gyms throughout the country offer the possibility to perform the sport regularly independently from the weather. As a result a variety of new pathologies like the closed flexor tendon pulley rupture of the finger and syndromes caused by overuse mainly in the upper extremity have appeared and should be familiar to physicians and therapists working in the field of sports medicine. An overview of the most common and most specific climbing related injuries as well as their diagnosis and treatment options with a focus on the upper extremity are presented.