Key findings:
- Slippers and boots are tied for the most emergency room visits on the list based on data from the U.S. Consumer Product Safety Commission
- Slipper injuries are typically far more serious than boot injuries
- High heels surprisingly send far fewer people to the ER than sandals and flip-flops
MOST DANGEROUS BY AMOUNT OF ER VISITS
| Rank | Footwear | ER Visits per Year | % Hospitalized | % With a Fracture | Most Injured Body Part |
|---|---|---|---|---|---|
| 1a | Boots | 20,840 | 7.9 | 11.8 | Foot |
| 1b | Slippers | 20,750 | 23.3 | 32.3 | Head |
| 2a | Flip-flops | 16,083 | 11.3 | 26.8 | Foot |
| 2b | Sandals | 15,961 | 9.5 | 24.1 | Foot |
| 3 | High heels | 10,290 | 3.4 | 25.7 | Ankle |
| 4 | Sneakers/athletic shoes | 8,630 | 7.4 | 16.3 | Foot |
Source: U.S. Consumer Product Safety Commission, National Electronic Injury Surveillance System (NEISS), 2021–2025. Visits are national estimates. Ties (1a/1b, 2a/2b) are within the statistical margin of error. Cases that don’t name a specific footwear type are not included.
MOST DANGEROUS BY SEVERITY OF INJURIES
| Rank | Footwear | % Serious Injuries | % With a Fracture | % Hospitalized | Serious Injuries per Year |
|---|---|---|---|---|---|
| 1 | Slippers | 40.3 | 32.3 | 23.3 | 8,359 |
| 2 | Flip-flops | 30.9 | 26.8 | 11.3 | 4,965 |
| 3a | Sandals | 27.9 | 24.1 | 9.5 | 4,451 |
| 3b | High heels | 26.3 | 25.7 | 3.4 | 2,708 |
| 4 | Sneakers/athletic shoes | 20.1 | 16.3 | 7.4 | 1,731 |
| 5 | Boots | 17.1 | 11.8 | 7.9 | 3,562 |
Source: U.S. Consumer Product Safety Commission, National Electronic Injury Surveillance System (NEISS), 2021–2025. Serious injuries are ER visits involving a fracture or ending in a hospital stay, with each visit counted once. Sandals and high heels (3a/3b) are tied within the statistical margin of error.
WHAT THE TWO RANKINGS TELL US
While boots and slippers are tied at number one for most dangerous types of footwear based on total ER visits, the severity of injuries effectively makes slippers the most dangerous type of footwear overall.
While boots are tied with slippers for the most common type of footwear involved in injuries, a lot of boot injuries are very minor in nature. Injuries involving slippers and flip-flops result in a much higher share of fractures and hospital stays than boots do.
High heels are surprisingly low for ER visits and only middle-of-the-pack for severity. With dozens of jokes about high heel injuries in television and movies, one might expect them to be higher on the two lists, or even top both lists.
It’s reasonable to say sneakers/athletic shoes are the safest type of footwear CPSC data can measure. They result in the fewest ER visits and are right above boots for severity of injuries.
HOW WE BUILT THESE RANKINGS
We created our rankings by analyzing data from CPSC’s National Electronic Injury Surveillance System (NEISS). We examined their annual files for 2021 to 2025 and determined which types of footwear send the most people to the hospital and which types result in the most serious injuries.
NEISS collects injury data from around 100 hospital emergency departments around the country and uses those hospitals as a representation for all emergency departments throughout the U.S.
All of the cases NEISS collects have a statistical weight. When you add up the weights, you get a national estimate for ER visits. Each case comes with a narrative written from the ER record to explain the conditions of the visit.
Through NEISS codes, we were able to isolate visits specifically involving footwear. We were then able to sort by types of footwear. Over 58% of footwear cases don’t name a specific type of footwear and aren’t included in these rankings.
Our severity ranking was determined by combining the share of ER visits involving a fracture or ending in a hospital stay. Every estimate meets CPSC’s reliability guidelines.
Our ties were determined by differences that were smaller than the statistical margin of error.
SAFETY TIPS
Even though footwear risks are sometimes unavoidable because we all need to wear shoes, the Centers for Disease Control and Prevention has some tips to keep you safe.
A fact sheet from CDC says falls are the leading cause of injury for older adults ages 65 and up. They say soft or stretched uppers allow the foot to slide around in the sole and lack of laces means the foot can slide out of the shoe.
CDC’s tips include:
- Avoid walking in only socks both inside and outside your home
- Don’t wear shoes with heels over one inch or with no ankle support
- Avoid shoes with no back
- Have your feet measured
- Shop for shoes later in the day to ensure a proper fit
- Accommodate foot deformities
Sources for this article include the U.S. Consumer Product Safety Commission and the Centers for Disease Control and Prevention.
