Box lacrosse is typically penalized with expulsion and suspensions. In 1990, when the Six Nations created the new Mohawk lacrosse league, fighting was specifically targeted as unacceptable. Violators were ejected from the game in which the altercation occurred and given a minimum three game suspension. Box lacrosse is the most popular version of the sport in the Czech Republic. It is also played to a marginal degree in Australia, primarily by players who have played field lacrosse. Club level box lacrosse leagues in the United States have increased the number of players exposed to the sport, including the: Baltimore Indoor Lacrosse League,
Box lacrosse places at the World Indoor Lacrosse Championships. Lacrosse is a traditional indigenous people's game and was first encountered by Europeans when French Jesuit missionaries in the St. Lawrence Valley witnessed the game in the 1630s. Lacrosse for centuries was seen as a key element of cultural identity and spiritual healing to Native Americans. It originated as a field game and was adopted first by Canadian, American, and English athletes as a field game, eventually settling on a 10 v 10 format. Box lacrosse is a modern version of the game that was invented in Canada during the 1920s and 1930s.