Ernest Hemingway watched bulls charge through Pamplona's cobblestone streets in 1925 alongside a handful of local youths testing their nerve. A century later, up to 3,500 runners from 50 countries clog the same route each morning during San Fermín. The transformation of this centuries-old tradition from local ritual to international tourist spectacle reveals an uncomfortable truth: as Pamplona's bull run became safer in some ways, it grew more dangerous in others.

The numbers tell a stark story. When TIME magazine covered the event in 1932, "hundreds of youths" participated in what the publication called a driving of bulls, not yet the Running of the Bulls. By the early 1970s—after Hemingway's novel The Sun Also Rises became required reading for a generation of travelers—the festival began attracting serious international attention. Today, Pamplona's population of 200,000 swells to over 1 million visitors during the nine-day festival. The route that once accommodated a few dozen runners now strains under thousands.

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Then: A Local Tradition (1974 and Earlier)

Who Ran: Before 1974, only men could officially participate. Local Navarrans dominated the encierro, joined by French tourists from nearby resort towns. American participation was minimal despite Hemingway's influence—his romanticized accounts hadn't yet translated into mass tourism. The runner-to-bull ratio allowed experienced locals to guide the herd with some degree of control.

The Medical Response: Basic at best. A handful of medical personnel stationed at the bullring treated injuries after the fact. Serious gorings meant delayed transport to hospitals with no specialized trauma systems in place. The 1977 death of Jose Joaquin Esparza, who suffocated in a pile-up at the bullring entrance, highlighted the dangers of crowd crush with inadequate emergency response.

Speed and Duration: Bulls routinely took 4-5 minutes to complete the 875-meter route through Santo Domingo, Mercaderes, Estafeta, and Telefónica sections. The pace allowed for some recovery and repositioning along the way.

Rules and Enforcement: Informal guidelines passed down through local knowledge. Women were officially prohibited from running until 1974. No standardized enforcement existed—runners learned by watching or from family members who'd participated for generations.

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Now: An International Phenomenon (2024)

Who Runs: Approximately 19% of runners are American, drawn by bucket-list tourism and social media documentation. Between 2,000 and 3,500 participants crowd the route each morning—a number that would have been unimaginable in Hemingway's era. Only 5 women have been gored since 1974, though female participation has grown steadily. The overwhelming majority are tourists experiencing their first and only run.

The Medical Response: 200 medical professionals collaborate daily, including physicians and nurses at 16 sanitary posts positioned every 50 meters. Twenty ambulances stand ready along the route. The system can now stabilize and transport a gored person to the hospital in under 10 minutes. Most volunteers come from the Red Cross. In 2024, 6 people were injured including one gored—typical numbers for a modern festival where 50-100 people require medical attention annually.

Speed and Duration: Modern bulls, bred specifically for strength and speed at farms in Andalucía and pre-trained by running daily, can reach 24 mph on straightaways. The run now typically lasts under 3 minutes, sometimes as brief as 2 minutes. Faster bulls mean less reaction time and more violent collisions with walls and runners.

Rules and Enforcement: Pamplona now publishes official regulations in multiple languages and broadcasts announcements before each run. Strict requirements include being 18 or older, wearing proper footwear, and maintaining 0.0% blood alcohol content. Cameras, cell phones, backpacks, and any object that could hinder runners are prohibited. Runners cannot incite bulls, must run in straight lines, and face detention, arrest, or ejection for violations. An ongoing working group of city officials continuously evaluates and adjusts safety measures.

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What Got Safer

The infrastructure improvements are undeniable. Double wooden fencing systems—constructed from approximately 3,000 separate pieces—create escape gaps wide enough for humans but too narrow for bulls. Pastores (herders in green shirts) strategically position themselves along the route with long poles to prevent isolated bulls and assist fallen runners. Multi-language safety briefings reach international participants who might otherwise have no context for what they're attempting.

The last death occurred in 2009 when Daniel Jimeno Romero was fatally gored near the Telefónica building. Since record-keeping began in 1910, 16 people have died—the same death toll reported in 2024, suggesting no additional fatalities in 15 years despite exponentially more participants.

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What Got More Dangerous

The crowd itself has become the primary hazard. With thousands of runners on a route designed for dozens, the risk of trampling now exceeds the risk of goring. The narrow Callejón section and bullring entrance act as funnels where pile-ups regularly occur—most injuries now come from other runners rather than bulls. Cebada Gago bulls have caused more gorings than any other breed since 1985, but even they can't navigate a sea of bodies.

The first morning's run remains the most dangerous, logging the highest injury and death counts historically. Yet inexperienced tourists disproportionately choose this day, creating a perfect storm of overcrowding and incompetence. Social media has incentivized reckless behavior—runners attempting to photograph themselves or record video while running violate rules designed to prevent exactly these distractions.

Medical costs have escalated alongside participation. A single day in a Pamplona hospital can cost 2,000 euros, while surgery for serious gorings reaches 11,000 euros. Many foreign runners lack adequate insurance coverage. The festival was cancelled in 2020 and 2021—the first interruptions since the Spanish Civil War in the 1930s—due to COVID-19, revealing how dependent Pamplona's economy has become on this high-risk tourism.

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Pamplona's transformation over 50 years created a paradox: better medical care and safety infrastructure can't eliminate risks that multiply with overcrowding. The ratio of runners to bulls has gone off the charts, and most participants are hurt by other runners moving at high speed through narrow streets. A 1932 spectator might not recognize today's run—where the greatest danger often comes from the person next to you, not the half-ton animal charging behind you.