Many British towns have played Shrovetide down the centuries but Ashbourne is one of the few to carry on the tradition. Only twice has it been cancelled, in 1968 and 2001 - both times because of an outbreak of foot and mouth disease. It continued through both world wars.
And it has had the royal seal of approval - in 1928, the then-Prince of Wales (who would later become King Edward VIII) threw in the ball to start the game. In 2003, Prince Charles had the honour of being the so-called 'turner-up.'
"Plenty of people seem to have tried over the years to stop this great tradition of Shrovetide," the Prince said hours before the 2003 game, "but even over the two world wars, the men on active service wrote asking it should be carried on. Now why was it that they did that? Because, they said, it was one of the things they were fighting for, part of the old traditional England that has survived innovations and inventions.
"All I can say is you've got to keep it going, somehow or other."
Ashbourne, a quaint, picturesque town in the central English county of Derbyshire, virtually shuts down for the two-day event.
Schools and businesses are closed. Shops on the high street and other nearby thoroughfares are boarded up to stop their windows getting smashed. Signs approaching the town centre state: 'Cars are parked at their owners' risk.'