Background: This review aims to analyze injury epidemiology and specific biomechanical risk factors in table tennis training among university physical education (PE) students, and to synthesize evidence-based prevention strategies applicable in academic settings.

Methods: This is a narrative review based on a synthesis of peer-reviewed literature from academic databases. The analysis focuses on table tennis injury epidemiology, risk factors in non-elite and collegiate athletes, injury biomechanics, and injury prevention interventions (including neuromuscular training, core stability, and kinetic chain exercises).

Results: Evidence suggests that PE students are a high-risk group, with reported injury rates up to 11.7 per 1000 hours of physical education activity, significantly higher than the general physically active youth population. This is largely attributed to the burden and structure of the academic curriculum. The most common injury sites in table tennis include the upper extremities (shoulder, 22.0%; elbow, 19.4%; wrist, 16.4%) and lower extremities (ankle, 17.2%; knee, 11.9%–26.0%). Key identifiable risk factors include improper training load (TL) management, with injury rates increasing significantly as relative load per minute increases. Critical biomechanical factors include Scapular Dyskinesis, a condition increasing shoulder pain risk by 43%; restricted thoracic spine mobility; proprioceptive deficits in the lower extremities; and poor core stability. Non-elite athletes (such as PE students) exhibit a distinct injury profile compared to professionals, with a higher prevalence of lower extremity injuries.