Data regarding risk and rates for head injury and concussion specific to the sport of synchronized skating is absent from literature. This study differentiated team level-based rate and risk for head injury and concussion, identified behaviors to include education, baseline screening and protective equipment utilization, and the implementation of return to play protocols. An anonymous cross-sectional survey was implemented at the 2018 U.S. Synchronized Skating Championships. Participants were female members of a qualifying team, ages 13 and older, intermediate participation level and higher. The survey response rate was 42% (520/1,232). Among the survey respondents, 7% (36/520) reported head injury in the practice setting and 1% (4/520) in the competitive setting. Among respondents who reported head injury (n = 37), 68% (25/37) reported a team skill injury, with senior level reporting the highest 22% (13/75) rate. Among the sample population (n = 520), the odds of sustaining a head injury during a team skill was 2.13 times more likely than during individual skill (OR: 2.13, CI: 1.06, 4.30; p = 0.03). The odds of sustaining a head injury during practice was 9.59 times higher than in competition (OR: 9.59, CI: 3.30, 27.15; p < 0.0001). Among the sample population, 36% (188/520) reported receiving concussion education during the past training year and 8% (44/520) reported hitting their head on the ice and returning to skating without seeking medical consultation. A χ2 analysis did not reveal a significant association between education and return to skating without medical consultation X2 (1, n = 520) = 0.391, p = 0.532. Baseline screening was reported among 25% (128/520) of the survey respondents. Only 0.06% (3/520) of the survey respondents reported utilizing protective headgear. Among those reporting concussion (n = 26), 92% reported receiving a return to sport/learn progression. Emphasis on concussion education and medical provider access should be targeted to team skill development in the practice setting.