Ladder injury statistics: 189,958 ER visits in 2025
Ladders send more people to the emergency room than any other tool. Who gets hurt, how, and how to set a ladder up properly.
In 2025, extension, straight and unspecified ladders were involved in an estimated 174,512 US emergency room visits, and stepladders in another 15,446. That puts ladders far ahead of every other tool type we track. They are also among the most serious: 21.8% of ladder ER visits end in hospital admission or transfer, against an average of under 10% for hand tools.
Older adults are hit hardest
30% of people treated for ladder injuries in 2021–2025 were 65 or older. The most common diagnosis is fracture (35%), and the most often injured body part is the head.
| Ladder type | ER visits 2025 | Admitted | Aged 65+ |
|---|---|---|---|
| Ladders (extension & unspecified) | 174,512 | 21.8% | 30% |
| Stepladders | 15,446 | 17.2% | 50% |
Set it up by the 4:1 rule
OSHA requires the base of a leaning ladder to sit one quarter of its working length away from the wall. For a support point 16 feet up, that is 4 feet out. If you are stepping onto a roof, the rails must extend 3 feet above the edge. Use the calculator above to get both numbers and the duty rating you need.
- Keep three points of contact: two hands and a foot, or two feet and a hand.
- Do not stand on the top step or top cap of a stepladder.
- Move the ladder instead of leaning out. Keep your belt buckle between the rails.
- Check the duty rating against your weight plus tools and materials.
Full data: Ladders (extension & unspecified) · Stepladders.