Introduction:
Sport climbing has grown in popularity in recent years. During this activity, the main exercise is made by the upper limbs which carry the largest load. Almost half of climbing injuries concern fingers with most frequent injuries of flexor tendon pulleys.

Aim:
The aim of this work is to present risk factors, clinical picture, current diagnostic methods and treatment of finger flexor pulley injury of sport climbers.

Material and methods:
The attempt was made to characterize finger flexor pulley injury of sport climbers. Using keywords 'pulley,' climbing,' 'rupture,' injury' we performed a review of relevant articles based on a PubMed search, focusing on last five years.

Results and discussion:
The amount of mechanical load that climbers apply to each finger depends on several hand grips specific to sport climbing. Repetitive loading of the pulleys with high forces can bring on injury and overuse syndromes. The grading system for flexor pulley injuries was proposed by Schöffl et al. to help guide and correlate therapeutic options.

Conclusions:
The main causes of pulley injury include the lack of proper warm-up before training, a lack of stretching and cool down the body's muscles after workout, too short time intervals between each workout and repetitive overuse. The diagnosis of pulley disruption is based on the injury history, clinical examination and visualization by ultrasound or a magnetic resonance imaging. Grade 1–3 pulley injuries can be managed conservatively, grade 4 injuries require a surgical repair.