Context: As the number of injuries in young soccer players increases, an epidemiological study is the first step in improving preventive strategies. Objectives: To analyze the injury profile of a Spanish professional soccer club’s academy during 4 consecutive seasons and to examine the injury incidence across different chronological age groups. Design: Prospective cohort design. Setting: Aggregate injury and exposure data collected during 4 consecutive seasons. Participants: Three hundred nine elite male young soccer players. Main Outcomes Measures: Injuries that led to participation time missed from training and match play prospectively reported by medical or coaching staff of the club. Results: A total of 464 time-loss injuries were observed during this study period. The overall injury incidence was 2.93 injuries per 1000 hours, with higher incidence during matches than during training (10.16 vs 2.10 injuries/1000 h; rate ratio [RR] = 0.21; 95% confidence interval [CI], 0.17–0.25; P < .05), with the U14 age group presenting the lowest injury rate (2.39 injuries/1000 h; RR = 1.15–1.57; P < .05). In terms of injury severity, moderate injuries were the most frequent (1.42 injuries/1000 h). Muscle injuries were the most common type of injuries (57.7%; 2.75 injuries/1000 h; RR = 1.84–13.4; P < .05), and hamstrings (93/268) were the most affected muscle group (0.58 injuries/1000 h; RR = 1.58–2.91; P < .05). Injury incidence showed a seasonal variation as indicated by peaks in August and October. In matches, specifically, the match period between 75 and 90 minutes showed the highest injury incidence (10.29 injuries/1000 h; RR = 1.89–6.38; P < .01). Conclusions: The findings of this study suggest that specific preventive strategies must be implemented to try to reduce the injury incidence in Spanish elite young soccer players attending to the characteristics of each age group.