This population-based study reports the cumulative incidence of agricultural injuries during a 1-year period in a sample of 998 farmers aged 55 years and older living in Kentucky. A total of 98 farm-related injuries were reported among 88 older farmers for a crude injury rate of 9.03 injured farmers per 100 farmers (95% confidence interval (CI) = 7.03-11.03) over a 1-year period. The leading external causes of farm injury were falls (24.9%), machinery (22.5%), wood-cutting (14.6%), and animal-related events (14.3%). Farmers working on farms with beef cattle (alone) (odds ratio = 1.90; 95% CI = 1.02-3.55) or farms with beef cattle and tobacco (odds ratio = 2.15; 95% CI = 1.00-4.59) had a statistically significant increased risk for a farm-related injury. Farmers reporting a prior injury that limited their ability to farm were at increased risk for a farm-related injury. Approaches to using farm injury surveillance data for injury control programs in the state are discussed.