Rock climbing and its sub-disciplines, for example bouldering, competition climbing, sport climbing, are very popular in all age groups. An increasing number of indoor climbing gyms offer the possibility to perform the sport regularly independent from weather and daylight. As the sport applies high forces onto the fingers, new pathologies like closed finger flexor tendon pulley injuries and epiphyseal fractures of the fingers in young climbers occur. Also sport-specific overstrain syndromes have become known and should be known 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 are presented.