Medial elbow injuries in the throwing athlete are common and increasing in frequency. They occur due to repetitive supraphysiologic forces acting on the elbow during the overhead throw. Overuse and inadequate rest are salient risk factors for injury. Most athletes improve substantially with rest and nonoperative treatment, although some athletes may require surgical intervention to return to play. Because of advances in conservative and surgical treatments, outcomes after medial elbow injury have improved over time. Currently, most athletes are able to return to a high level of play after ulnar collateral ligament reconstruction and experience a low rate of complications.