Background: The present study assesses the frequency of injury in Europe’s top-level judokas, during top-level competitions, and defines risk factors. Methods: The members of the EJU Medical Commission collected injury data over the period of 2005 to 2020 using the EJU Injury Registration Form at Europe’s top judoka tournaments. Results: Over the 15 years of the study, 128 top-level competitions with 28,297 competitors were included; 699 injuries were registered. Of all competitors, 2.5% needed medical treatment. The knee (17.4%), shoulder (15.7%), and elbow (14.2%) were the most common anatomical locations of injury. Sprains (42.2%) were by far the most frequent injury type, followed by contusions (23.1%). Of all contestants, 0.48% suffered an injury which needed transportation to hospital. There was a statistically significant higher frequency of elbow injuries in female athletes (p < 0.01). Heavy-weight judokas suffered a remarkably low number of elbow injuries, with more knee and shoulder injuries. Light-weight judokas were more prone to elbow injuries. Conclusions: We found there was a low injury rate in top-level competitors, with a greater frequency of elbow injuries in female judokas. During the 15 years of injury collection data, an injury incidence of 2.5% was found, with a remarkable high injury rate in the women’s −52 kg category, and statistically significantly more elbow injuries in women overall.