Importance Pickleball has experienced a surge in participation over the past decade, yet the epidemiology of pickleball-related ocular injuries remains unexplored. Objective To assess the incidence of and examine demographic factors associated with pickleball-related ocular injuries over the past 20 years. Design, Setting, and Participants This cross-sectional study used the National Electronic Injury Surveillance System (NEISS) database published by the US Consumer Product Safety Commission, which is based on a nationally representative probability sample of hospitals in the US and its territories. A population-based sample of cases was obtained by selecting patients who presented to NEISS-affiliated emergency departments with pickleball-related ocular injuries from 2005 to 2024. This resulted in a weighted estimate of ocular injuries nationally. Data were analyzed from October 6, 2024 to July 9, 2025. Exposure Participation in pickleball. Main Outcomes and Measures The main outcomes were the unweighted number and weighted number (percentage) of pickleball-related ocular injuries. Demographic information including age, sex, treatment year, and laterality of the injury were collected. The mechanisms of eye injuries and types of eye injuries were also assessed. Results Between 2005 and 2024, there were an estimated 3112 (unweighted n = 73) pickleball-related ocular injuries with an estimated 1262 (unweighted n = 33) ocular injuries occurring in 2024 alone. Based on a survey-weighted linear regression, the estimated incidence of pickleball-related eye injuries increased by 405 cases (95% CI, 288-522 cases; P = .004) annually from 2021 to 2024. There were more pickleball-related ocular injuries among patients aged 50 years or older than among patients younger than 50 years (difference, 39%; 95% CI, 6%-65%; P = .03). Severe eye injuries included retinal detachment, orbital fracture, globe trauma, and hyphema. Mechanisms of injury included direct hit by a pickleball, direct hit by a paddle, and falls. Conclusions and Relevance This study found that pickleball-related eye injuries have increased at an alarming rate over the past 4 years as the sport continues to grow in popularity. Eye protection is not currently mandated for casual or professional play. Establishing standardized guidelines for eye protection is recommended to reduce the risk of ocular injuries among players.