Five people have been hospitalised with a range of injuries after participating in the opening bull run of the San Fermin festival in Pamplona, Spain.
Two American men and three Spanish men were injured during the event on Sunday, according to Spanish officials.
A 46-year-old man from San Francisco was gored in the neck, a 23-year-old from Kentucky and a 40-year-old Spanish national were both gored in the thigh.
Two Spanish men sustained head injuries, according to a statement from the Royal Navarre Hospital.
The running of the bulls gathers crowds of around a million people every year. Throughout the nine-day festival, six bulls are run through the narrow streets every morning.
Runners sprint alongside the bulls, often dressed in white and red.
The bulls are then killed by professional matadors in afternoon bullfights.
Red Cross emergency personnel cared for 48 people with less serious injuries, including those who were trampled by the bulls, reports BBC.
At least 16 people have died since 1910 when records of the events began.
Animal activists protested the festival on Friday by outlining their bodies in chalk in the shape of a bull, wearing horns and lying on the pavement with fake spears protruding from their backs.