Figures released by the Government's accident compensation arm show almost 27,000 new claims from 2010-15.
And 2015 was the worst year, with the most new claims, 5208, and the most money paid out at $5,669,229.
But St John Central Lakes territory manager Kelvin Perriman said while the number of injuries might have increased, they were not as horrific as in years gone by.
"I remember 15 to 20 years ago when you were getting some serious injuries.
"It was before helmets and wrist-guards were common.
"We'd see horrific head injuries but that's rare now off the skifields.
"The culture has changed.''
St John handles the transfers for ACC patients. The organisation brings an extra six ambulance staff to Queenstown over the winter.
"Anecdotally, this year we believe we'll have the least transfers off the mountains.
"That's a combination of a few things; the slower start to the ski season, now we've actually got really good snow, and also the safety standards have improved at the fields.''
Mr Perriman said they were predominantly transferring patients with minor fractures.
NZSki contractor Medical Rescue deals with minor injuries at Coronet Peak and the Remarkables.
More skiers than snowboarders were injured over the five years, although numbers were relatively close - 13,913 skiers against 12,780 snowboarders.
The cost of ski-related injuries is significantly higher, $18,300,492 versus $11,435,135 for boarders.
The statistics cover skiing and snowboarding across the whole district, so Wanaka fields Cardrona and Treble Cone are included, as well as heli-skiing and boarding and private trips up the mountain.
Proactive Physio Queenstown's senior physiotherapist Catherine Jensen said: ``I see a lot of knee injuries coming off the mountain, most involving the meniscus and ligaments that surround the knee.''
Ms Jensen said resolving any muscle imbalances and improving leg, hip and core strength pre-season could help, along with a good warm-up and easing into skiing on the day.
ACC spokeswoman Stephanie Melville said the majority of claims were for minor injuries such as bruising, sprains and strains.
But the sports were a great way to keep active, she said.
"[But] it's important to remember they're physically demanding activities which often involve challenging terrain, so following safety guidelines is a must.''
