Injuries of pulleys are quite common in mountain climbing. The clinically diagnosed rupture of a pulley can now be verified by MRI. Partial ruptures, which in MRI always showed as scars, can frequently lead to intrinsic bow-stringing. The injuries were primarily treated non-surgically. With regard to chronic, recurring cases or large ruptures, however, annular ligament plastics have to be considered. As a prophylaxis we recommend special training exercises for climbers on wide ledges with changing exertion patterns and a tape-bandage for the fingers. During climbing, the PIP-joint should best not be strained in an obtuse angle. Warming-up and stretching exercises before climbing are absolutely necessary.