BACKGROUND: Neuromuscular training programs have shown to decrease injury rates in sport specific domains; however, there is limited research in non-sport populations. OBJECTIVE: Examine the effectiveness of reducing sport injury through a high intensity, neuromuscular training program aimed at school youth. DESIGN: Pilot, randomised controlled trial. Participants were randomised by school, to either intervention or control programs in year one. Year two, the intervention program was implemented in the control school. SETTING: Physical education (PE) classes. PARTICIPANTS: 725 (year one) and 314 (year two) consenting participants aged 11–15. INTERVENTION: Intervention group completed a 15 min, high intensity, neuromuscular training warm-up, three times per week for 12 weeks. The control group warm-up was the same duration, with standard of care components. MAIN OUTCOME MEASUREMENTS: Sport injury, defined as any sport injury that required medical attention, and/or cessation of the activity, and/or time loss from sport. Secondary outcomes; aerobic fitness (VO2 maximum (ml/kg/min), vertical jump (cm) and balance (s). RESULTS: Incidence rate ratios (IRR), adjusted for clustering by class, previous injury and exposure hours, estimated the intervention program was protective of all sport injury (IRR=0.29 (95% CI 0.18 to 0.46)), lower extremity injury (IRR=0.30 (95% CI 0.17 to 0.53)), and time loss injury (IRR=0.43 (95% CI 0.20 to 0.94)). The intervention group showed greater improvement in aerobic fitness (2.14 ml/kg/min (95% CI 1.17 to 2.59)) (t=-3.86, p=0.0001) and vertical jump (4.16 cm (95% CI 3.65 to 4.66)) (t=-3.67, p=0.0003) compared to the control group. No statistical differences were detected in balance measures. CONCLUSIONS: A neuromuscular training program implemented in PE classes was protective of all sport injury, lower extremity injury and time loss injury. Results pertaining to year two will be determined and presented.