To assess their awareness and usage of mouthguard and occurrence of sports-related oral injuries in athletes who involve in various sports activities in Kota Bharu. A cross-sectional study was carried out among 180 athletes aged 12 to 27 years. A structured interviewer-guided questionnaire was used to determine the prevalence of oral injuries sustained during sport activities, the use of mouthguard as well as the athletes' awareness of mouthguard use. The respondents consisted of 107 males (59.5%) and 73 females (40.5%) with a mean age of 16.7 years (SD 5.53). There were 60 (22.2%) athletes who had one or more types of sports-related oral injuries sustained. Laceration of lips, tongue and gums were the most frequent injuries (57.5%) while loosening of teeth and fracture of teeth sustained in 12.5% and 10.0% of athletes respectively. Malay traditional martial arts silat athletes, 17(68.0%) experienced the highest oral injuries among athletes. The prevalence of oral injuries was significantly different between ball sports, martial arts and other non-contact sports (p=0.002). Sixty-one athletes (33.9%) reported that they were aware of mouthguard; however none of the athletes used the mouthguards during their sports activities. Malay traditional martial arts silat was the most common susceptible to sustain oral injuries. None of the athletes were wearing mouthguard. Education on prevention of orofacial trauma should be given to the coaches and athletes. Wearing of mouthguard during sport activities should be compulsory during practice and competition events.