The aim of this research work was to investigate and quantify the risk of fatal and fracture injury for Thoroughbreds participating in flat racing in the US and Canada so that horses at particular risk can be identified and the risk of fatal injury reduced. Risk factors associated with fatalities and fractures were identified and predictive models for both fatalities and fractures were developed and their performance was evaluated. Our analysis was based on 188,269 Thoroughbreds that raced on 89 racecourses reporting injuries to the Equine Injury Database (EID) in the US and Canada from 1st January 2009 to 31st December 2015. This included 2,493,957 race starts and 4,592,162 exercise starts. The race starts reported to the EID represented the starts for 90.0% of all official Thoroughbred racing events in the United States and Canada during the 7-year observation period.