Objective: To investigate whether the presence of fraternities and sororities was associated with a higher local injury rate among undergraduate-age youth. Methods: In 2016 we compared the rate of 2010-2013 youth (18-24 years) emergency department (ED) visits for injuries in Hospital Service Areas (HSA) with and without fraternities and sororities. ED visits were identified in the State Emergency Department Database (n = 1,560 hospitals, 1,080 HSAs, 16 states). US Census Bureau and National Center for Education Statistics sources identified HSA population and campus (n = 659) characteristics. A proprietary database identified campuses with fraternities and sororities (n = 287). ED visits explicitly linked to fraternities and sororities in the National Electronic Injury Surveillance System--All Injury Program were used to identify injury causes for sub-group analysis. Results: HSAs serving campuses with fraternities and sororities had lower age 18-24 injury rates for all causes except firearm injuries (no difference). Conclusions: Fraternities and sororities were not associated with a higher injury rate at the population level among undergraduate-age youth. A major limitation is not being able to observe campus health services utilization.