Introduction: Epidemiological analysis of buco-maxillo-facial (BMF) fractures is important to provide measures for preventive care and effective treatment of these injuries. Objectives: To verify the prevalence of sport-related accidents involving the BMF structure and factors associated with sport modality, and knowledge and use of mouthguards. Method: This was a cross-sectional, descriptive, survey-based study involving 647 athletes participating in different sports in a Brazilian city in 2019. Respondents answered a questionnaire that addressed the primary outcome - occurrence of trauma to the head and neck region during sporting activities - and the knowledge and use of mouthguards. The following variables were investigated: marital status, sex, age, education, sport, affected region, and cause and consequence of trauma. Results: One hundred forty-eight athletes (22.87%) sustained trauma during sporting activities/competition. The mouth was the most affected site (30.40%) and contact with an elbow was the main cause. In 80 (54.05%) athletes, trauma occurred during game conditions and 68 (45.95%) during training. A total of 536 athletes (82.84%) were familiar with the concept of wearing a mouthguard; however, only 169 (26.12%) actually used one, 13 (7.69%) of whom were fitted with a custom mouthguard recommended by a dentist. There was a significant association between the occurrence of BMF trauma (BMFT) and knowledge of mouthguards (p=0.0042), sport modality (p<0.0001), education (p<0.0001), age (p< 0.0001), and sex (p=0.0421). Conclusion: The occurrence of BMFTs in athletes was high. Although most were familiar with mouthguards, their use was not a usual practice.