Martial arts involvement is often described in controversial terms. On the one hand, it is associated with negative effects to social and personal well-being and with the stimulation of aggressive and violent behaviour of those involved. On the other hand, however, there is a belief that martial arts practice can lead to positive socio-psychological outcomes. This paradox caused a public discourse on the value and legitimacy as socially accepted sports, often leading to a categorization between “good” and “bad” styles of martial arts. Empirical proof that this “good versus bad” perspective divides along the lines of specific martial arts styles is missing up until now. Consequently, the distinct moral and medical concerns regarding the effects of involvement in harder martial arts—combined with their increased popularity, as well as their perceived positive outcomes for specific target groups—had the consequence that policy makers and administrators often struggle with the regulation and organisation of full contact martial arts. Some of them have started to develop (or rethink) their policy concerning the regulation and support of these sports. By means of a case study this paper discusses some of the key issues regarding the regulation of full contact martial arts (e.g., kick-/Thai boxing, MMA), which are considered to be problematic for (sport) authorities, and which confront sports policy makers in Flanders. These key issues are discussed from an organizational, pedagogical, ethical and medical, and governmental perspective. Furthermore, the different initiatives are described that Flemish policy makers have undertaken in response to the difficult issues related to full contact martial arts. Over a period of 17 months, a deeper insight into the organization and regulation of full contact martial arts in Flanders was obtained, using a number of means (i.e., document analysis, interviews with key witnesses, focus group discussions and observations of training sessions, competitions and events). This paper aims to highlight the need to develop a sound martial arts policy that can provide a legitimation base for the provision and organization of full contact martial arts, which have become increasingly popular in recent years.